Prevalence of Diabetes and Associated Conditions in Women Coming for Delivery in a Tertiary Care Centre of Kumaon Region of Uttarakhand

ABSTRACT

Introdution Diabetes in pregnancy either gestational or type1 or 2 is associated with morbidity for both the mother andfetus. It can lead to a lot of complications during antenatal,peripartum and postpartum period. Increased rate of LSCS,macrosomic fetus, difficulties during delivery (e.g. obstructedlabour, shoulder dystocia), congenital anomalies in the baby,stillbirth are very frequently associated with diabetes. ThisStudy was conducted to analyze the prevalence of diabetes(either Gestational or Pre-Gestational) and associatedconditions and draw a comparative evaluation in womencoming for delivery in the labour room of Govt. Medicalcollege, Haldwani , Uttarakhand.Material and methods: All the women who came fordelivery during the period from January 2017 to December2018 were tested for blood sugar regardless of whether theyare follow up patients or coming for the first time and alsoregardless of their antenatal history. After detailed history andexamination GCT with 75gm glucose was done. Dependingon the 2-hour glucose level and history, diagnosis of GDM orPre- Gestational diabetes were made.Result: During the study period total 8228 deliveries occurredin the labour room of Govt. Medical college, Haldwani,Uttarakhand. Of all these women 24(0.3%) were diagnosedwith GDM or DM by the history and tests conducted at thetime of admission. Of the 24 patients of diabetes 4(16.7%)were associated with Pregnancy induced hypertension, 6(25%)were associated with hypothyroidism and 10(41.7%) had noassociated condition. 9(36.7%) patients of the 24 deliveredbefore 36 week of gestational age and 15(73.7%) delivered atgestational age of more than 36 week. The mode of deliverywas LSCS in 19(79.16%) patients of the total 24 patients.Conclusion: Any form of diabetes either Gestational orPre-Gestational is a major cause of increased morbidity andmortality in pregnancy for both mother and fetus. Diabetes candevelop any time during pregnancy and so there are chance ofmissing on the diagnosis of diabetes by mere one time testingof blood sugar. So it is very necessary to keep repeating thesugar testing (glucose challange test) in a pregnant women at asignificant time interval. Even in women coming for deliveryirrespective of the history a blood sugar testing should be donenot only for diagnosis, but also for assessing the degree ofinsulin resistance.