Feto-maternal Outcome in Patients with Gestational Diabetes Mellitus in Western India: A Two Years Follow up Study

Objective: Untreated gestational diabetes mellitus (GDM) may lead to increased risk of macrosomia, congenital anomalies, unexplained stillbirth, hypoglycemia and jaundice in newborns. This prospective study was conducted to evaluate feto-maternal outcome in women with GDM. Materials and Methods: Two hundred pregnant women underwent 75grams glucose challenge test according to Diabetes in Pregnancy Study of India (DIPSI) criteria. All 26 GDM patients were managed by medical nutrition therapy (MNT), metformin and insulin. Monitoring was done through six-point and seven-point plasma glucose profile, anomaly scan between 18-20 weeks, every three weeks fetal sonography after 28 weeks, fetal echocardiography at 25 weeks, weekly non-stress test and amniotic fluid index after 32 weeks. Descriptive statistics and chi square were used to analyze data. Results: Mean (±SD) age of studied patients was 24.26 (± 3.75) years. Two (7.6%) patients with GDM developed vaginal candidiasis. Six (23.7%) patients underwent caesarean and two (7.6%) underwent vacuum-assisted delivery. One (3.8%) underwent spontaneous abortion. Neonatal outcome was affected by hyperbilirubinemia (12%) in three and shoulder dystocia in one (3.8%) neonate. Conclusion: Timely screening of all pregnant women for glucose intolerance, achieving euglycemia in them and ensuring adequate nutrition can reduce adverse feto-maternal outcomes and promote healthy families. The successful maternal, perinatal and neonatal outcome rests on both the obstetrician’s intrepidity and patients’ awareness of her condition, its implications, management and long term prospects.