ABSTRACT
Background: Diabetes in Pregnancy Study group, India (DIPSI) diagnostic criteria is a single step method of screening and diagnosis of gestational Diabetes. Therefore, this prospective study was undertaken to ascertain the validity of DIPSI criteria to diagnose GDM based on pregnancy outcome in Indian population.Method: The present Hospital based prospective study was conducted at OBGY department, GSL Medical College and General Hospital, Rajahmundry during 2013 to 2015. Women who were attending OBGY OPD for Antenatal check-ups within 24-28 weeks of GA during the study period were included in the study. Each mother at 24-28 weeks of gestation irrespective of last meal timing, fasting / non fasting was given 75 gm glucose dissolved in a glass of 200 ml water to drink and after two hours venous blood was collected.Result: Out of 500 cases, 26 cases are diagnosed as having gestational diabetes by DIPSI criteria and 474 cases are Normal glucose tolerant. Maximum number 53.9% of cases diagnosed as GDM by DIPSI are of age >25 yrs (53.9%), primigravida (65.7%), BMI>25 (57.7%). In present study, family h/o diabetes is a risk factor for GDMConclusion: Our results suggest that a policy of universal screening for GDM should be adopted in all antenatal clinics and 75 gm OGTT has a high predictive value. This single step procedure is a simple economic and feasible method. It serves both for the purpose of screening and diagnosis at the same time.
ABSTRACT
Background: Postpartum blood loss is difficult to evaluate especially in developing countries like India where most of the women are anaemic with poor reserve and these conditions are further aggravated by increased demand during pregnancy and blood loss during third stage of labour. The present study was planned to compare the efficacy of prophylactic 10 IU intramuscular oxytocin and 10 IU intramuscular oxytocin +1g Tranexamic acid in reducing blood loss in the third stage of labour.Methods: The present study was carried out on full term pregnancies primigravida/ multiparas with singleton pregnancy being delivered vaginally at GSL Hospital, Rajahmundry between 2016-2017 were included. For this comparative study, 200 women in labor were included after obtaining informed consent. A detailed obstetric history, history of previous medical illnesses, history of the treatment received earlier, cardiovascular and respiratory system and other systems including thyroid and breast were noted.Results: The average total blood loss in IIIrd stage of labour with IM oxytocin was 210 ml and with IM oxytocin + Tranexamic acid was130 ml, which was statistically significant (p<0.001). Oxytocin + Tranexamic acid group had less blood loss when compared to oxytocin group alone. Side effects like, nausea vomiting, headache were slightly more with oxytocin + Tranexamic acid group when compared to oxytocin group alone.Conclusions: In the active management of IIIrd stage of labour 10 IU intramuscular Oxytocin + one gram of tranexamic acid IV is a better combination in reducing the blood loss at delivery when compared to 10 IU intramuscular oxytocin alone.