RESUMEN
Gestational diabetes mellitus is the most common medical complication of pregnancy. It occurs in women who have insulin resistance and a relative impairment of insulin secretion. Identifying this group of women is important in not only preventing prenatal morbidity but also improving long-term outcomes for the mothers and their children[1]. Diagnosis and treating pregnancies complicated by gestational diabetes mellitus [GDM] are important for preventing adverse perinatal outcomes. Diagnosis is usually accomplished early in the third trimester of pregnancy because the insulin content of the amniotic fluid starts to increase between the 24[th] and 28[th] week of gestation[2]. The goals of treatment are to maintain blood glucose levels within normal limits during duration of the pregnancy or labor and ensure the well being of the fetus and mothers[3]. This study was conducted to identify problems that are found among parturient with gestational diabetes and assess pregnancy outcomes among parturient with gestational diabetes. A sample of 200 parturient women was selected from Zagazig University hospital or public Zagazig hospital with the following criteria: The women being in labor, having gestational diabetes and being either primigravida and multigravida. The women were selected from labor unit. The study tools included a questionnaire sheet. Maternal assessment sheet and neonatal assessment sheet using Apgar scoring, estimation of blood glucose level and assessment of the anthropometric measurements. The data were collected over a period of 12 months starting from May 2004 to the end of April 2005. The results revealed that, the most common maternal problems among parturient women on admission were polyhydramnios and vaginal infection in 20% and 22% respectively. Moreover, the quarter of the sample [25%] had preterm labor. Also three fourths of parturient women have encountered problems during labor [75%], the most frequent of these problems was cesarean section [60%]. Regarding the neonatal outcome, the results illustrated that the majority of neonates [82%] had their Apgar score at first minute between 5 and 7, at the fifth minute still about one third were in the range 0-4 while 24% reached the range 8-10. The most common neonates problems were hypoglycemia [54%], [50%] had macrosomia, 25% were preterm, and congenital anomalies accounted for 10% of the cases. So, it is recommended that women with gestational diabetes should be counseled regarding the potential hazards and risks involved for both maternal and neonatal outcome. Proper care during prenatal, natal and postnatal period can prevent maternal, fetal and neonatal complications through identifying those with higher risk of developing such complications, they should have a clear protocol for management of these complications