scholarly journals Screening of gestational diabetes mellitus using one-step versus two-step method: a comparative study

Author(s):  
Deepti Khenwar ◽  
Juhi Agarwal ◽  
Sushruta Shriastava

Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during the present pregnancy. It affects 7% of all pregnancies worldwide and in India it ranges from 6 to 9% in rural and 12 to 21% in urban area. The aim of this study was to compare the DIPSI criteria with the two-step method (Carpenter and Couston criteria.) and to study merits and demerits of one step and two step tests for GDM.Methods: A total 400 pregnant women of gestational age between 24-28 weeks attending antenatal clinic at this study tertiary care center were enrolled in this study. 200 pregnant women were enrolled in each of the study group (Group I OGTT and Group II DIPSI).Results: In Group I (OGTT) screening 47 (23.5%) were tested positive. In Group II cases, screening test results were found positive among 44 (22%). Out of 95 high-risk pregnant women 38 (40%) were positive for GDM by OGTT and 34 (35.78%) were positive by DIPSI. Out of 305 non high-risk pregnant women, 9 (2.95%) were positive for GDM by OGTT and 10 (3.27%) were positive by DIPSI.Conclusions: Present study concludes that DIPSI is the test which can predict GDM in population comparable to another test like OGTT. Also, India’s major population reside in rural areas, ANC are mostly conducted by ANM, therefore screening test should be easy to perform and interpret.

2021 ◽  
Vol 15 (10) ◽  
pp. 2753-2755
Author(s):  
Shazia Jamil ◽  
Naveed Mahmood ◽  
Israr-ul- Haque ◽  
Rabiah Haque ◽  
Muhammad Imran-ul-Hasan ◽  
...  

Objective: To determine the prevalence of vitamin B-12 deficiency in pregnant women with gestational diabetes mellitus. Study Design: Retrospective study Place and Duration of Study: Department of Medicine, OMC Hospital, Jail Road Lahore from January, 2020 to December, 2020. Methods: Two hundred and thirty pregnant females were enrolled age between 18-45 years. Detailed demographics of enrolled cases age, gestational age, gravidity and body mass index were recorded after taking informed written consent. Among 230 cases, 100 women were non GDM (group I) and 130 had gestational diabetes mellitus (group II). Blood samples were taken from all the patients for measuring vitamin B12 status. Vitamin B12 was defined as <300 pg/ml. Results: Mean age of the patients in group I was 31.64±7.45 years with mean BMI 25.88±8.65 kg/m2 while mean age among GDM group was 34.55±5.71 years with mean BMI 27.36±9.44 kg/m2. Mean gestational age in group I was 33.72±4.21 weeks and in group II 35.08±9.27 weeks. In group I 20 (20%) had vitamin B12 deficiency and in group II rate ofvitamin B12 deficiency was high among 90 (69.2%) cases. We found a significantly relation between vitamin B12 and GDM with p value <0.0007. Conclusion: The prevalence of vitamin B-12 deficiency among pregnant women of gestational diabetes mellitus was significantly high as compared to normal pregnant women. Keywords: Pregnant Women, Gestational Diabetes Mellitus, Vitamin B12 deficiency


2009 ◽  
pp. 73-86
Author(s):  
Renata Tambelli ◽  
Manuela Errante

- In this review are discussed the main researches about high-risk pregnancy and, particularly, gestational diabetes mellitus (GDM). The results of these researches highlight that pregnant women with GDM are extremely vulnerable, anxious and worried. However there are not many clinical studies about the effect of GDM on the quality of mother-child relationship.


2021 ◽  
Vol 15 (10) ◽  
pp. 3394-3396
Author(s):  
Bushra Mehmood ◽  
Anisa Saleem ◽  
Rubina Kausar ◽  
Amna Aslam

Objective: The aim of this study is to determine the adverse adverse maternal and fetal outcomes in teenage pregnant women. Study Design: Randomized controlled trial Place and Duration: Department of Gyne & Obs, Shahida Islam Teaching Hospital Lodhran, during from 15-04-2020 to 31-03-2021. Material and methods: Total one hundred and twenty patients were enrolled in this study. Patients were aged between 14- 40 years. Patients detailed demographics were recorded after taking written consent. Patients were equally divided into two groups I and II. 60 patients of aged between 14-18 years were included in group I and equally patients of aged >18 were included in group II. Frequency of pre-eclampsia, gestational diabetes mellitus and post-partum haemorrhage were calculated. Adverse outcomes among (cesarean section, instrumental delivery,induction of labor and prolong labor, hypertensive disorder) were calculated among both groups. Fetal outcomes Perinatal mortality, Low birth weight, Low Apgar score and NICU admission were observed. Complete data was analyzed by SPSS 22.0 version. Results: Mean age of the patients in group I was 17.88±1.42 years with mean BMI 22.09±4.66 Kg/m2 and in group II mean age was 19.16±8.64 years with mean BMI 23.87±4.57 Kg/m2. Fetal outcomes, perinatal mortality in group I 8 (13.3%) and in group II was 5 (8.3%), low birth weight in group I was among 25 (41.7%) and in group II was 9 (15%), low apgar score in group I was 10 (16.7%) and in group II was 7 (11.7%), 12 (20%) in group I went to NICU admission and 4 (6.7%) patient in group II admitted to NICU. Frequency of pre-eclampsia in group I were high among 27 (45%) patients as compared to group II 13 (21.7%) patients , frequency of gestational diabetes mellitus in group I was among 14 (23.3 %) patients and 5 (8.3%) patients were in group II, post partum haemorrhage was seen in 42 (70%) cases in group I and 23 (38.3%) cases in group II. Conclusion: Delaying intrauterine development and premature neonatal intensive care admissions are also on the rise in this study. Anemia, urinary tract infection, high blood pressure pregnancy, and surgical delivery are all associated with pregnancies in which the mother is a teenager. Keywords: Pre-eclampsia, Partum haemorrhage, Maternal outcome, Fetal outcome


2021 ◽  
Vol 1 (1) ◽  
pp. 57-59
Author(s):  
Sumi Singh

Gestational diabetes mellitus (GDM) can be defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Screening for GDM is done usually at 24-28 weeks of gestation. In this case a 27-year-old primigravida who was diagnosed as GDM after a one step approach at 22 weeks of pregnancy. Institution of management early by the help of one step diagnosis was associated with successful outcome. The case highlights the importance of diagnosing GDM early especially in developing countries where resources are limited.


2002 ◽  
Vol 95 (9) ◽  
pp. 435-439 ◽  
Author(s):  
Rafael Perea-Carrasco ◽  
Rocio Pérez-Coronel ◽  
Rogelio Albusac-Aguilar ◽  
Manuel Lombardo-Grifol ◽  
Elena Bassas-Baena De León ◽  
...  

The conventional screening test for gestational diabetes mellitus is measurement of plasma glucose 1 hour after 50 g glucose by mouth. The sensitivity and specificity of this test are lower than desirable; we therefore developed an index including other plasma constituents. In a preliminary study, 138 pregnant women had the standard oral glucose load screening test, and plasma fructosamine and total proteins were measured, in addition to glucose, in the 1-hour samples. An index value (I) was calculated as [fructosamine (μmol/L)÷total proteins (g/L)]×[glucose (mmol/L)÷100]. Cut-off values for I were then assessed in a second prospective study, of 642 pregnant women. Definitive diagnosis of gestational diabetes was by oral glucose tolerance test (OGTT). The index was also assessed in terms of fetal macrosomia (birthweight ≥ 4000 g). With a cut-off value of I=27.2, sensitivity was 98%, specificity 89%, diagnostic efficiency 90%, positive likelihood ratio 8.76. Application of the index would have avoided 42% of the OGTTs demanded by the standard screening test, reducing false positives from about 24% to 10%. Predictive efficacy for macrosomia was 10.3% versus 7.9%. Our index offers an efficient screening test for gestational diabetes, and with more stringent cut-off points may be applicable as a single-step diagnostic procedure.


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