ABSTRACT
Background: Gestational diabetes is defined as impaired glucose tolerance with onset or first recognition during pregnancy. Undiagnosed or inadequately treated gestational diabetes can lead to significant maternal and fetal complications. Even though there are guidelines for diagnosis of GDM (gestational diabetes mellitus) by the Government of India, there is poor penetration of the implementation throughout the nation.Methods: The study was conducted in A. J. Institute of Medical Sciences between April to June 2019. 56 patients were evaluated with the fetal medicine foundation GDM risk calculator to assess the risk for gestational diabetes in a retrospective approach.Results: Incidence of GDM in the study was 15.9%. At a cut-off of 1/80, the calculator predicted increased risk for 37 out of 56 patients. There was a sensitivity of 91.6% and specificity of 63.6% with a negative predictive value of 96.5% and positive predictive value of 29.5%. there was a false positive rate of 43.2%.Conclusions: The fetal medicine foundation GDM risk calculator will prove to be an invaluable tool to predict high risk patients who need closer monitoring of blood glucose into the third trimester.
ABSTRACT
Background: Cesarean section is one of the most commonly performed abdominal operations on women in most countries. The incidence of primary LSCS is increasing all over the world, Consequently, there is a rise in multiple repeat LSCS with associated complications. Previous LSCS is a common indication for repeat LSCS. Primarily, authors aim at studying the influence of repeat LSCS on maternal and fetal outcome in a tertiary centre.Methods: All mothers with one previous LSCS admitted for emergency/elective LSCS at term gestation with singleton pregnancy in A.J. Institute of Medical Sciences and Research centre, Mangalore were recruited in the study from July to December 2018. Detailed history with antenatal risk factors were noted. Intraoperative and postoperative events were noted. Neonatal outcome was also noted correlated.Results: Majority of patients (58%) were in age group of 20-24years. Most of them were between 38 to 39 weeks of gestation. Most common intraoperative complication was bladder adhesion (18% of cases). In postoperative period febrile morbidity (7%) was common followed by urinary tract infection (2%). Most of the neonates (80%) weighed 2.5 to 3kg at birth. The incidence of poor APGAR respiratory distress, NICU admission was not significantly increased. There were 5 morbidly adherent placenta, 1 scar rupture, 4 scar dehiscence, no maternal or perinatal death.Conclusions: Previous caesarean is the most common cause of repeat caesarean and is associated with maternal morbidity. Measures should be taken to reduce primary caesarean sections which indirectly reduces the incidence of repeat cesarean sections.