Gestational diabetes, the UHWI experience

ABSTRACT

Between 1985 and 1991, 1,276 patients with diabetes mellitus in pregnancy were either supervised or personally managed by the author at the University Hospital of the West Indies (UHWI). The perinatal mortality rate (PMR) was 60/1000 for this group of high-risk patients. There were eight cases of congenital malformation and 22.5 percent of the deliveries were preterm. The caesarean section rate was 33.6 percent which is twice that for the general obstetric population. Using the diagnostic criteria set by WHO (1980), 184 patients were classified as gestational diabetes mellitus (GDM). The principles of management of diabetes mellitus in pregnancy are reviewed. Population studies from the UDOP suggest the prevalence of diabetes to be 17 percent. In light of this, a pilot study of routine testing of all antenatal mothers at UHWI was initiated in January 1994. One thousand (1000) consecutive patients were enlisted and the protocol of testing is shown. The results will be discussed. (AU)