Abstract

Aims and Objectives: To study Prevalence of gestational diabetes mellitus and adverse pregnancy outcomes. Material and Methods: This prospective study was carried out at tertiary care hospital over a period of 2 years in 700 patients between 24 to 34 weeks of gestation, attending the antenatal outdoor based on laboratory investigation. These patients were given 100 gm oral glucose and there plasma glucose was estimated at fasting, 1st hour, 2nd hour, 3rd hour using Carpenter and Coustan criteria. The statistical analysis done by Chi-square test. Result: The Prevalence of GDM was 8.00%, while Impaired GTT was 12.86% and Normal patients were 79.14%. The incidence of GDM in primigravida was 14.3%, in secondgravida is 37.5%, in thirdgravida is 48.2%. It was seen that as the parity increases the incidence if GDM is also increases this was statistically highly significant ( χ2 = 174.2 ,df=4, P< 0.000 ) . The risk of adverse maternal outcome overall was higher in women with GDM compared with normal women. Women with GDM were at increased risk of developing pre-eclampsia (58.3), abruptio placenta (16.7), polyhydramnious (8.3%) urinary tract infection (8.3%), and postpartum haemorrhage (8.3%).The incidence of shoulder dystocia in GDM patient is 50% as compared to euglycemic patient its 29.4%. In GDM patient incidence of macrosomia is 33.3%. Incidence of fetal demise in GDM patient is 16.7% and in eglycemic patient its 11.8% . NICU admission was near about equal in normal GTT patient and GDM patient, that was 4% in normal GTT patient and 3.6% in GDM patient. NICU admission in GDM patient was due to hypoglycaemia and hyperbilirubinaemia. This observed difference was statistically significant (χ2 = 9.820 ,df=2, P<0.007). Conclusions: Prevalence of GDM in this study found to be 8%. Which is not small and cannot be ignored thus GTT test to be done as screening test in pregnant women. In our study we found that incidence of GDM increases with increase in parity. Outcomes of pregnancy of patient of GDM shows significantly raised incidence of preeclampsia, abruptio placenta, macrosomia and NICU admission for more than 24 hours compared to euglycemic patient deliverd in our hospital. We recommended that all antenatal patients should be screened for GDM.

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