Outcome of pregnancy with abnormal glucose metabolism

ABSTRACT

To study the perinatal outcome in women with abnormal glucose metabolism.Screening and Diagnosis All pregnant women at 24 to 28 weeks gestation without any historic or clinical risk factors were screened by a standard 50 g oral glucose challenge test. Venous plasma glucose values after one hour were abnormal if >/= 7.2mmol/l. Patients with associated risk factors or with abnormal glucose screening test were subjected to a three hour oral glucose tolerance test after three days of at least 200 g of carbohydrate diet and 50 g oral glucose. Fasting values of 5.8 mmol/l and 1,2 and 3 hour values of 9,7 and 5.8 mmol/l were considered abnormal. When both one and two hour values were elevated patients were categorised as having gestational diabetes mellitus [GDM]. Those with any other one or two raised values were assigned to hyperglycemia group [HGG]. During a two year period of 1993 and 1994, 1829 patients delievered in Sultan Qaboos University Hospital, out of which 80 patients were found to have hyperglycemia and 71 GDM. Ten patients were known to have diabetes mellitus from one to twelve years. Since this number was very small they were included in GDM group for statistical purposes. Incidence of HG and GDM+DM was 4.3% and 4.4% respectively. Treatment All patients were treated with diet. Insulin was added if considered necessary. All were followed up at regular intervals. Outcome HGG GDM+DM. - [No.80] [No. 71+10].- Macrosomia 3.75% 8.64%.- Shoulder dystocia 1.20% 2.40%.- Caesarean section 10.00% 17.28%.- The perinatal mortality and morbidy can be considerably reduced by good control of maternal hyperglycemia