ABSTRACT
Background: Gestational diabetes mellitus [GDM] is associated with increased perinatal morbidity and mortality, along with maternal complications in future
Objective: The objective of this study was to determine the diagnostic accuracy of 50 gram oral glucose challenge test in the screening of gestational diabetes mellitus
Patients and Methods: It was cross sectional study conducted in obstetrics and gynecology outpatient department of Bahawal Victoria Hospital, Bahawalpur, from 1[st] March, 2013 to 31[st] October, 2013, to determine the diagnostic accuracy of 50 gram oral glucose challenge test in screening of gestational diabetes mellitus [GDM]. Sample size calculated for the study at 5% precision, 8% anticipated proportion of GDM and expecting the sensitivity and specificity as 95.3% and 48.6% respectively, from formula of sensitivity and specificity, was 416. Four hundred and sixteen primigravida and multigravida women of age 20-40 years with singleton pregnancy at 24-28 weeks of gestation visiting the obstetrics and gynecology outpatient department selected by non-probability convenient method were included in the study. 50 gram oral glucose in 250 ml of plain water was given to each participant, after one hour venous blood sample was withdrawn to measure serum glucose level and 140 mg/dl was taken as cut off value for labeling the patient as screen positive or negative. Regardless of the results of 50 gram oral glucose challenge test all the participants were further evaluated by oral glucose tolerance test [OGTT]. Before doing OGTT all the patients were advised to come in the morning with overnight fast of 8-12 hours [plain water was allowed]. After taking blood samples for fasting blood glucose level, 75 gram oral glucose was given and after two hours blood glucose level was measured again. Fasting blood glucose level >/=110mg/dl and after 2 hours of taking 75 gram oral glucose, serum level of >/=160mg/dl was taken as cut off values to label as test positive or negative. Data was entered and analyzed by using SPSS version 17. Accuracy of OGCT in terms of sensitivity, specificity, positive predictive value and negative predictive value was measured by assuming OGTT as gold standard test
Results: Gestational diabetes mellitus was recorded in 22.59% on OGCT. On OGTT 19.95% were found to have GDM. Sensitivity was calculated as 85.54%, specificity 93.03%, positive predictive value 75.53% and 96.27% negative predictive value
Conclusion: Our results suggest that 50 gm OGCT is a test with high accuracy and can be used as a screening test for GDM in all antenatal clinics
ABSTRACT
Ovulatory dysfunction is a group of disorders with variable clinical presentations occasionally having serious long-term adverse effects. It accounts for 30% of female fertility problems. Evidence suggests an association between an individual's weight and disorders of ovulation. The objective of our study was to describe the clinical and hormonal profile of subfertile women with ovulatory dysfunction in relation to their body mass index [BMI]. This prospective, descriptive study was carried out in Mother and Child Health Centre, PIMS, Islamabad and railway hospital, Rawalpindi from April 2001 to March 2007. One hundred and thirty eight infertile patients with ovulatory dysfunction were included. The clinical data including BMI of each patient was recorded in addition to reports of investigations comprised of cervical smear, pelvic ultrasound and hormonal profile. Primary infertility was found in 61% while secondary in 39% of the patients. The mean age was 29 years and mean duration of infertility was 6 years. Menstrual pattern was normal in 56.5%. BMI was normal in 30.4% while most patients were overweight and obese. Prolonged cycles, history of systemic endocrine disorders, abnormal vaginal -discharge, hirsutism, polycystic ovarian morphology and hormonal abnormalities are more frequent in overweight than infertile patients with ovulatory dysfunction having a normal BMI