Medication Safety in Obstetrics and Gynecology Ward in Jayanagar General Hospital, Bangalore, India

2021 ◽  
Vol 15 (5) ◽  
pp. 1270-1275
Author(s):  
S. Ferdousmakan ◽  
Namitha K.B ◽  
M. Etesami
Keyword(s):  
Diabetes Mellitus ◽  
Folic Acid ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Drug Interactions ◽  
General Hospital ◽  
Medication Safety ◽  
Relevant Information ◽  
Obstetrics And Gynecology ◽  
Iron Folic Acid

Objective: The present study is aimed at Medication Safety in Obstetrics and Gynecology Ward in Jayanagar General Hospital, Bangalore, India Methodology: It is a prospective observational study, conducted in the inpatient obstetrics and gynecology ward in Jayanagar General Hospital. The study was conducted for 6 months. CRF (Case record form) was designed to record the clinical profile and treatment pattern which contains patient demography, family history, past medication history, obstetric history and follow up and further medication safety was assessed in the patient according to WHO and US-FDA guidelines. The patient demographics and all medically relevant information were noted in a predefined data collection form. Alternatively, these case charts were reviewed for prescription legibility and completeness, unaccepted abbreviations, the capture of relevant information in case sheets, contraindication, drug interactions, and adverse drug events. Result: The data of 150 pregnant women admitted to obstetrics and gynecology ward for delivery related care during the period October 2018 to April 2019 were analyzed. It was observed that 20.67% had Hypertension, 14.67% had Gestational diabetes mellitus, and 8.67% had urinary tract infections as major comorbidities. Among the study population most of them 20.67% had oligohydramnios as a major pregnancy risk factor followed by 12% of preeclampsia and 3.33% of small for gestational age. A total of 1950 drugs were prescribed, and thus the average number of drugs per patient was 13.28. Iron, folic acid, calcium, and vitamins were the most frequently used drugs during the pregnancy. Category A drug constituted 623(54.50%) followed by category B drug 398(34.82%) out of 1950 drugs used in pregnant subjects. Another category C, D and X were 6.99%, 3.5% and 0.1% respectively. The most common drug interaction was found to be between Metronidazole and ondansetron, which may be due to high usage of tramadol and metoclopramide in pregnancy. Conclusion: Among the study patients most them 75.33% were in the age group of 21-30 years. Most of the 20.67% and 14.67% had hypertension and gestational diabetes mellitus as co- morbidities. On the review of 150 prescriptions, the average number of drugs prescribed was found to be 7.62. Iron, folic acid, calcium, and vitamins were the most frequently used drugs during the pregnancy. Most of the used drugs were from Category A (54.50%). Only 0.1% of the drug were from Category X. There were 183 possible risks of major potential drug interactions. The most common interaction was between Metronidazole and ondansetron. The majority of the drugs were prescribed as per FDA category A, the safest category during pregnancy. Keywords: Medication Safety, Obstetrics, Gynecology, pregnancy

scholarly journals Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Min Zhao ◽  
Shuyu Yang ◽  
Tzu Chieh Hung ◽  
Wenjie Zheng ◽  
Xiaojie Su
Keyword(s):  
Diabetes Mellitus ◽  
Folic Acid ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
International Association ◽  
White Cell Count ◽  
Increased Risk ◽  
Iadpsg Criteria ◽  
Laboratory Biomarkers

AbstractGestational diabetes mellitus (GDM) has aroused wide public concern, as it affects approximately 1.8–25.1% of pregnancies worldwide. This study aimed to examine the association of pre-pregnancy demographic parameters and early-pregnancy laboratory biomarkers with later GDM risk, and further to establish a nomogram prediction model. This study is based on the big obstetric data from 10 “AAA” hospitals in Xiamen. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. Data are analyzed using Stata (v14.1) and R (v3.5.2). Total 187,432 gestational women free of pre-pregnancy diabetes mellitus were eligible for analysis, including 49,611 women with GDM and 137,821 women without GDM. Irrespective of confounding adjustment, eight independent factors were consistently and significantly associated with GDM, including pre-pregnancy body mass index (BMI), pre-pregnancy intake of folic acid, white cell count, platelet count, alanine transaminase, albumin, direct bilirubin, and creatinine (p < 0.001). Notably, per 3 kg/m2 increment in pre-pregnancy BMI was associated with 22% increased risk [adjusted odds ratio (OR) 1.22, 95% confidence interval (CI) 1.21–1.24, p < 0.001], and pre-pregnancy intake of folic acid can reduce GDM risk by 27% (adjusted OR 0.73, 95% CI 0.69–0.79, p < 0.001). The eight significant factors exhibited decent prediction performance as reflected by calibration and discrimination statistics and decision curve analysis. To enhance clinical application, a nomogram model was established by incorporating age and above eight factors, and importantly this model had a prediction accuracy of 87%. Taken together, eight independent pre-/early-pregnancy predictors were identified in significant association with later GDM risk, and importantly a nomogram modeling these predictors has over 85% accuracy in early detecting pregnant women who will progress to GDM later.

scholarly journals Folic acid deficiency related to hyperhomocystinemia has less correlation with Gestational Diabetes Mellitus (GDM)

2016 ◽  
Vol 6 (1) ◽  
pp. 1-7
Author(s):  
Shamim Ara Begum ◽  
Ibrahim Khalil ◽  
Chanchal Kumar Mandal ◽  
Md Moynul Hasan ◽  
Mohammad Ali Kawsar
Keyword(s):  
Diabetes Mellitus ◽  
Folic Acid ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Metabolic Enzyme ◽  
Control Group ◽  
Case Group ◽  
Folic Acid Deficiency ◽  
Acid Deficiency ◽  
The Mean

Gestational diabetes mellitus (GDM) is a different degree of the glucose intolerance that begins during pregnancy. GDM affects maternal and child health and is associated with a potential for preeclampsia, caesarean delivery due to macrosomic baby and type 2 diabetes in the mother, and with higher rates of perinatal mortally and many abnormalities in the infant. Homocysteine is a naturally occurring amino acid. Hyperhomocysteinemia(Hcy) is increased homocysteine levels which are associated folic acid deficiency. Hcy is regulated by several factors including genetically determined metabolic enzyme alteration, nutritional status, underlying disease, certain medication, age and pregnancy. A total of (40 case+40control) 80 patients are included in this study, it was observed that majority 21(52.5%) patients were age belonged to 31-35 years in case group and 17(42.5%) patients were age belonged to 31-35 years in control group. The mean age was found 30.5±4.2 years in case group and 29.05±4.2 years in control group. Majority 19(47.5%) patients had 3rd gravida in case group and 20(50.0%) patients had 3rd gravida in control group. Majority patients BMI belonged to 25-29.9 kg/m2 (over weight) in both groups which was 21(52.5%) in case and 32(80.0%) in control group. The mean BMI was found 28.9±3.4 kg/m2 in case and 28.53±2.9 kg/m2 in control group. The difference was not statistically significant (p>0.05) between two groups. Studies have shown that folate deficiency is associated with increased homocysteine levels in blood.Update Dent. Coll. j: 2016; 6 (1): 01-07

scholarly journals Gamma-glutamyl transferase is an indicator of gestational diabetes mellitus

2016 ◽  
Vol 44 (3) ◽  
pp. 152-156 ◽  
Author(s):  
Mousumi Ghosh ◽  
Debatosh Paul ◽  
Md Saiful Islam ◽  
Gopal Chandra Ghosh ◽  
Mohammad Monzurul Alam Bhuiyan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Obstetrics And Gynecology ◽  
Gamma Glutamyl Transferase ◽  
Cross Sectional ◽  
Gamma Glutamyl ◽  
Group I ◽  
Glutamyl Transferase

Increased gamma-glutamyl transferase (GGT) is associated with gestational diabetes mellitus (GDM) and type 2 diabetes mellitus in pregnant women. This cross sectional study was conducted in the Department of Clinical Pathology in collaboration with Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from March 2014 to February 2015 to assess the GGT as an indicator of GDM. Total 66 pregnant women were enrolled in this study in the Department of Obstetrics and Gynecology, BSMMU. Total 33 cases were considered as Group I (GDM) and 33 controls were Group II (normal healthy pregnant women). Two ml of blood was collected in plain test tube from each patient. Gestational diabetes mellitus were diagnosed by FBS and 2hr after 75g glucose in this study as cases. Normal healthy pregnant women was included in this study as control. GGT was higher in GDM group compared to normal healthy pregnant women (30.60±7.78 vs. 16.45±4.97, p<0.001). So, with the help of GGT we can take preventive measure and precaution to reduce the risk of GDM in pregnant women.Bangladesh Med J. 2015 Sep; 44 (3): 152-156

scholarly journals Myoinositol plus α-lactalbumin supplementation, insulin resistance and birth outcomes in women with gestational diabetes mellitus: a randomized, controlled study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rosario D’Anna ◽  
Francesco Corrado ◽  
Saverio Loddo ◽  
Giuseppe Gullo ◽  
Loretta Giunta ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Folic Acid ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Clinical Outcomes ◽  
Fetal Growth ◽  
Treated Group ◽  
Abdominal Circumference ◽  
Reduce Insulin Resistance

AbstractTo verify whether myo-inositol plus α-lactalbumin may reduce insulin resistance and excessive fetal growth in women with gestational diabetes mellitus. In a 12-month period, 120 women with a diagnosis of gestational diabetes mellitus were consecutively enrolled with an allocation of 1:1 in each group and randomly treated with myo-inositol plus α-lactalbumin plus folic acid (treated group) or folic acid (control group) for 2 months. Primary outcome was the variation of insulin resistance through the study evaluated by HOMA-IR. Secondary outcome was the evaluation, through the study, of fetal growth by ultrasound measurements of abdominal circumference centiles and estimated fat thickness. Some clinical outcomes were also considered. After 2 months, in the treated group, a significant reduction in insulin resistance (HOMA values 3.1 ± 1.4 vs 6.1 ± 3.4, p = 0.0002) and fetal growth was shown (Abdominal circumference centiles 54.9 ± 23.5 vs 67.5 ± 22.6, P = 0.006). Among clinical outcomes, a significant decrease in the rate of women who needed insulin (6.7% vs 20.3%, p = 0.03) and of pre-term birth (0 vs 15.2%, p = 0.007) was evidenced. A combination of myo-inositol and α-lactalbumin may reduce insulin resistance and excessive fetal growth.Clinical trial registration: ClinicalTrials.gov, http://www.clinicaltrials.gov, NCT 03763669, first posted date 04/12/2018; last posted date December 06/12/2018.

scholarly journals The Associations between the Duration of Folic Acid Supplementation, Gestational Diabetes Mellitus, and Adverse Birth Outcomes based on a Birth Cohort

2019 ◽  
Vol 16 (22) ◽  
pp. 4511 ◽  
Author(s):  
Gang Cheng ◽  
Tingting Sha ◽  
Xiao Gao ◽  
Qiong He ◽  
Xialing Wu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Folic Acid ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Birth Outcomes ◽  
Linear Models ◽  
Folic Acid Supplementation ◽  
Adverse Birth Outcomes ◽  
Adjusted Relative Risk ◽  
Increased Risk

This study aimed to examine the associations between the duration of folic acid (FA) supplementation, gestational diabetes mellitus (GDM), and adverse birth outcomes. A total of 950 mother-offspring pairs participated in the cohort study during 2015 in Changsha, China. The data were collected through home visits and perfected by maternal and child healthcare handbooks. Generalized linear models and stratified analyses were used for statistical analyses. The incidence of GDM in our cohort was 10.2%. FA supplementation for ≥3 months before pregnancy was associated with an increased risk of GDM (adjusted relative risk (aRR): 1.72; 95% CI: 1.17–2.53) and decreased risk of small-for-gestational-age (SGA) birth (aRR: 0.40; 95% CI: 0.18–0.88). In the group of FA supplementation for ≥3 months during pregnancy, GDM was associated with an increased risk of cesarean delivery (aRR: 1.36; 95% CI: 1.06–1.75) and macrosomia (aRR: 2.11; 95% CI: 1.06, 4.20), but the aRRs were lower than the RRMH 1.53 (95% CI: 1.01–2.34) and 2.43 (95% CI: 1.27–4.66). Our study suggested that the longer duration of FA supplementation before pregnancy might increase the risk of GDM, but decrease the risk of SGA birth. Longer duration of FA supplementation during pregnancy had beneficial effects on birth outcomes in women with GDM. Further studies should consider a larger sample size to confirm these findings.

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