ABSTRACT
Background: Diabetes mellitus is a chronic metabolic disorder characterised by polyuria, polyphagia, polydipsia and glycosuria. Diabetes in pregnancy can be defined as pregestational (pre-existing) diabetes or gestational diabetes have type 1 (T1DM) or type 2 (T2DM) diabetes mellitus. Present study was carried to compare the maternal and perinatal outcome of overt diabetes mellitus as compared to gestational diabetes mellitus (PGDM) with that of gestational diabetes (GDM).Methods: An observational study was conducted at obstetrics and gynaecology department of a tertiary care center from July 2010 to October 2012 among 23 diabetic women. Seven of them were cases of overt diabetes while 16 were diagnosed during pregnancy. Maternal and fetal outcome were studied. All patients were followed from time of admission to discharge from hospital.Results: mean age of the participants were 26.71±4.89 in overt diabetes as compared to 27.56±4.41 among gestational diabetes. Illiteracy, low socio-economic status, rural residence, family history of diabetes was also high in overt diabetes mellitus as compared to GDM but none of them was statistically significant (P < 0.05). Intrauterine fetal death was more among GDM (37.5%) as compared to overt diabetes (28.57%). Prematurity and LBW were also high in overt diabetes as compared to GDM but none of them were statistically significant. Oligohydramnios, polyhydramnios and premature rupture of membrane were higher in gestational diabetes mellitus as compared to overt diabetes among women. Rate of LSCS were higher in gestational diabetes.Conclusions: Diabetes whether over or gestational is responsible for the poor outcome of the pregnancy so tight control is needed.
ABSTRACT
Background: Authors estimate that 15.6 million abortions (14.1 million-17.3 million) occurred in India in 2015. Incomplete abortion is a known disadvantage of medical method of abortion reported in 0.2-3% of cases. Though Misoprostol can be used with different routes including oral, sublingual and vaginal, few evidences are available in drug effectiveness as well as its related side effects when used through different routes and more so in India. The present study is aimed to compare the efficacy of misoprostal in first trimester abortion when taken vaginally as compared to orally. Thus, whichever route results in lower rates of incomplete abortions, can be employed in our health set up, minimizing the complications of failed first trimester MTP.Methods: An experimental study was conducted on 74 women seeking termination of pregnancy within 9 weeks of amenorrhea during the period of 9 months in a tertiary care institute. Tablet mifepristone 200 mg was given to all participants. After 48 hours, 37 women were given 800 mcg tablet of Misoprostol for oral consumption while other 37 women were given 800 mcg Misoprostol for self-administering vaginally. Abortion status and complications were checked.Results: The complete abortion rates in vaginal group and oral group were 97.3% and 86.49 % respectively. Satisfaction was more in case of vaginal misoprostol, while side effects were similar in both groups.Conclusions: Mifepristone with vaginal misoprostol was more effective as compared to oral misoprostol for first trimester abortion.