Top PDF Clinical study of fetomaternal outcome of diabetes mellitus in pregnancy

Clinical study of fetomaternal outcome of diabetes mellitus in pregnancy

Clinical study of fetomaternal outcome of diabetes mellitus in pregnancy

The prevalence of GDM varies from 4% to 14% depending on the population and the diagnostic methods performed. In India, rates of GDM are estimated to be 10-14.3% which is much higher than the west. In a field study in Tamil Nadu, performed under the Diabetes in Pregnancy- Awareness and Prevention project, of the 4151,3960 and 3945 pregnant women screened in urban, semi- urban and rural areas, respectively, the prevalence of GDM was 17.8% in the urban, 13.8% in the semi urban and 9.9% in the rural areas. The incidence of GDM is expected to increase to 20% i.e. one in every 5 pregnant women is likely to have GDM by 2020.In India, because of ethnicity,universal screening is recommended by Govt of India. Universal screening of all patients attending antenatal clinic by doing OGCT with 75gm glucose is done at the first antenatal visit.
Show more

107 Read more

Clinical study of fetomaternal outcome of diabetes mellitus in pregnancy

Clinical study of fetomaternal outcome of diabetes mellitus in pregnancy

NO NAME AGE IP NO PARITY FAMILY H/O PREV OBS H/O, GDM H/O WT GAIN kg BMI GCT RX PREECL MODE OF DELIVERY SEX B.WT kg TERM/ pre term 5’ APGAR NICU TERM 9 NIL 36.[r]

34 Read more

A Clinical Study on Gestational Diabetes Mellitus and
Pregnancy Induced Hypertension.

A Clinical Study on Gestational Diabetes Mellitus and Pregnancy Induced Hypertension.

Acohort study analyzed the risk factors for PE and GH with 10,666 pregnant women in Sweden and found; the risk for development of preeclampsia is high with GDM mother 207 . Study by Ingrid Ostland et al 208 , with 430,852 women, suggests that there is an independent and significant association between GDM and preeclampsia. In GDM patients the high blood pressure early in pregnancy, even prior to gestational diabetes diagnosis, were associated with the subsequent development of preeclampsia 209 . In a retrospective cohort study of more than 111,000 pregnancies found that women with GDM were 2.5 times more likely to experience preeclampsia than without diabetes 210 .One other large, population-based study conducted in Latin America with 878,680 pregnancies demonstrated an association between GDM and preeclampsia 211 . Vambergue et al 212 from France studied in 15 maternity units found an association between PIH and GDM. Since some of the risk factors are common for both disease the coexistence of both disease may worsen the pregnancy outcome. Increased maternal age, nulliparity, and multiple gestation pregnancies could be identified as common risk factors for both diseases 213 . one study with 24,290 singleton pregnancies, reported that carbohydrate intolerance of varying severity are increased risk factors for developing PIH and the same time both conditions share the common etiology 214 . Preeclampsia has been frequently reported as a complication of GDM 215 . But the relationships between these two conditions were not well established.
Show more

175 Read more

Gestational diabetes mellitus with its maternal and foetal outcome: a clinical study

Gestational diabetes mellitus with its maternal and foetal outcome: a clinical study

Results: Out of 476 patients attending the antenatal outdoor at the Umaid Hospital, Jodhpur, Rajasthan, India. The prevalence of gestational diabetes in present study was 7.98%, Incidence of GDM found to increase with increasing age with maximum prevalence (10.71%) in more than 30 years age group, with increasing parity, low socioeconomic strata and in urban population. With maximum prevalence amongst higher parities (12.5%) in >G5 and higher). The incidence was higher with history of PIH (36.36%), family H/O DM (33.3%), GDM (12.12%), perinatal losses (15.15%), anomalous baby (9.09%), high BMI (67%). GDM complicate the normal course of pregnancy with increased incidence of PIH (36.4), Polyhydramnios (27.2%), infections like vaginal candidiasis (24.2%) and UTI (39.3%). The infant of diabetic mother had 12 (32.29%), 9 (26.47%), 11 (32.35%), 8 (23.53%) 5 (14.70%) and 3 (8.82%) of hypoglycemia, respiratory distress, macrosomia, congenital anomalies, birth injuries, polycythaemia, and hypocalcaemia respectively in diabetic mothers with suboptimal glycaemic control during pregnancy.
Show more

7 Read more

Pregnancy complicated by cardiac disease: fetomaternal outcome

Pregnancy complicated by cardiac disease: fetomaternal outcome

Patients were monitored for fluid overload using input /output monitoring and chest auscultation during labour. Outlet forceps or vacuum extractor were used judiciously to shorten second stage of labour. Following delivery, injection frusemide 20 mg was given intravenously. Appropriate measures were taken to avoid thromboembolism. Women having mechanical prosthesis on anticoagulants were admitted in early pregnancy (6-12 weeks) and again in the third trimester (≥36 weeks pregnancy) for switchover from oral anticoagulants to heparin. Heparin was stopped at the onset of labor and restarted 12 hrs after vaginal delivery and 24 hrs after caesarean section. In both cases, warfarin was started 2 days after delivery and overlap was done till International Normalized Ratio (INR) of 2.0 to 3.5 was achieved. Early ambulation was ensured. Patients remained in hospital for at least 3-5 days postpartum depending on the clinical condition. Postdelivery evaluation and counselling by cardiologist was done with stress on optimisation of cardiac status prior to next pregnancy. Facility for HDU and ICU care was available if needed. Maternal outcome was analysed on the basis of mode of delivery, presence of co morbidities like: Anaemia, Gestational Diabetes Mellitus, Pregnancy induced hypertension, APH (Placenta Previa and abruption) and Postpartum haemorrhage. Cardiac complications such as pulmonary edema, deterioration in NYHA, arrhythmia were recorded.
Show more

7 Read more

Effect of first trimester maternal serum pregnancy associated plasma protein: a level on fetomaternal outcome

Effect of first trimester maternal serum pregnancy associated plasma protein: a level on fetomaternal outcome

early abortion stillbirth, intrauterine uterine growth retardation (IUGR), gestational diabetes mellitus (GDM), intrauterine death (IUD), preterm delivery, Pregnancy- induced hypertension (PIH) is still being studies. Morris RK et al, reviewed 32 studies and concluded that first trimester low maternal serum PAPP-A is associated with adverse pregnancy outcomes, but predictive values are poor and further work should be done to address PAPP-A as an adverse prognostic marker. 4

7 Read more

Prospective study of fetomaternal outcome in epilepsy in pregnancy in a tertiary care hospital

Prospective study of fetomaternal outcome in epilepsy in pregnancy in a tertiary care hospital

Results: This study showed that the incidence of epilepsy in pregnancy in our hospital is 0.6%. 86.36% of patients were treated with antiepileptic medications during their pregnancies. Pregnancy complications were anemia, gestational diabetes mellitus, gestational hypertension, intrauterine growth retardation, premature rupture of membrane, and vaginal bleeding. Live birth rate was 91.82%. Low birth weight babies were recorded in 24 (21.82%) infants. Only one baby had congenital anomaly of cleft lip and palate.

5 Read more

Study of fetomaternal outcome in gestational diabetes mellitus

Study of fetomaternal outcome in gestational diabetes mellitus

The condition occurs exclusively in the antenatal period where there is certain physiological maladaptation in the regulation of carbohydrate metabolism in pregnancy that turns out to be pathological, contributing to the onset and progression of the condition. It can cause a wide range of complications as well as long term implications in both the mother and fetus. The severity of the condition should not be overlooked. The International Diabetic Federation found that one out of seven births in India is affected by GDM. A large proportion of women also progress to become overt diabetics in the future hampering their quality of life by causing morbidity in various forms.
Show more

129 Read more

Clinical study of Hypothyroidism in patients of Diabetes Mellitus

Clinical study of Hypothyroidism in patients of Diabetes Mellitus

Meckel (1806) was probably the first person to describe systematically the physiological enlargements of the thyroid in relation to adolescence, menstruation, defloration and pregnancy. Hippocrates gave practical association of various features of exophthalmic goitre. Juvenal’s query “who wonders at a swollen throat in the Alps?” indicates that goitre was endemic in that area in the first century. Sir Robert Mecarrision studied the goitre in the foothills of Himalayas in 1905 for 30 years. Early concepts about the etiology of goiter were thought to be due to drinking water coursing through limestone deposits or drinking snow water.
Show more

112 Read more

Obstetrical outcome in gestational diabetes mellitus: a retrospective study

Obstetrical outcome in gestational diabetes mellitus: a retrospective study

GDM onset is associated with various factors such as age, parity, BMI, pervious history of GDM and family history of diabetes. In the present study all above factors were studied, however due to unavailability of BMI details, its association in development of GDM was not analysed. Among 286 women, majority of them the women were aged between 25-30years accounting to 163 (57%) women. Among 44 women (15.4%) who were ≥31years, 11(25%) women had GDM, while 33(75%) women were normoglycaemic throughout the pregnancy. In our study the onset of GDM was seen more common among women between 25-30year age group (62.7%) compared to 18.6% women who were ≥31 years (p= 0.321) (Table 1).
Show more

8 Read more

Diabetes mellitus in pregnancy : a clinical and public health problem

Diabetes mellitus in pregnancy : a clinical and public health problem

The strength of this review comes from the comprehensive evaluation of the available evidence on the effectiveness and safety of PCC together with the assessment of wide range of interventions which we considered as PCC and all the possible maternal, fetal and neonatal outcomes which are affected by maternal pre-GDM. We are aware of the limitations of the observational studies as the main source of evidence and the inherent bias associated with the design; however, randomized controlled trials to assess the effectiveness of PCC are neither ethical nor feasible. Nevertheless the nature of the intervention lent strength to the observational studies by avoiding certain biases known to occur in such study designs. Lack of allocation concealment and blinding of participants were avoided by recruiting the intervention and the control groups at different times during the course of the study (preconception period and antenatal period). Additionally, and due to the relatively short duration of the pregnancy, attrition bias was minimized.
Show more

57 Read more

The impact on clinical outcome of high prevalence of diabetes mellitus in Taiwanese patients with colorectal cancer

The impact on clinical outcome of high prevalence of diabetes mellitus in Taiwanese patients with colorectal cancer

There are some limitations of the present study. First, the present study is a single-institution retrospective study. The diagnosis of DM was made according to the records of the charts. Therefore, some patients who had DM may be diag- nosed to be non-DM. Second, the severities of comobidities were not assessed. The presence of a comorbidity occurs in only a relatively small group of patients, and is also the limitation of the current study for the further stratification of severities of comorbidity between DN and non-DM patients. Third, the types of treatment, length of treatment, and, treatment-related toxicities were also not assessed. Consequently, the present study is not necessarily represen- tative of Taiwan as a whole. Finally, as in the majority of the literature, we did not differentiate the types of DM. The mean age of the patients with diabetes was 67 years; the majority of patients with diabetes were supposed to have type 2 DM. In addition, the unavailability of serum level of HbA1c is also a limitation of the present study. Siddiqui et al. reported that elevated HbA1c is an independent
Show more

9 Read more

A prospective study on pregnancy complicated with jaundice with special emphasis on fetomaternal outcome

A prospective study on pregnancy complicated with jaundice with special emphasis on fetomaternal outcome

Present study was a prospective study. The study was conducted on 58 cases of pregnant women with jaundice (serum bilirubin ≥3 mg%) admitted at Panna Dhay Zanana Hospital (PDZH), RNT Medical College, Udaipur, Rajasthan from January 2016 December 2016. The diagnosis of each case of jaundice in pregnant women was based on clinical evaluation, biochemical and hematological parameters and in all cases foetomaternal outcome analysed in detail as follows:

8 Read more

Spot protein/creatinine ratio as a marker for fetomaternal outcome in hypertensive disorder of pregnancy

Spot protein/creatinine ratio as a marker for fetomaternal outcome in hypertensive disorder of pregnancy

Optimizing the timing of delivery involves striking a balance between the benefits and risks of pregnancy prolongation compared with those of induction or elective cesarean delivery. Birth of the baby is always in the best interest of the woman. However, we do recognize that women with severe pre-eclampsia remote from term with clinical evidence indicative of fetal compromise (e.g., absent or reversed end-diastolic flow by umbilical artery Doppler) may best be delivered by Caesarean section. Out of 100 hypertensive patients in our study, 57 underwent a cesarean section and 43 underwent a vaginal delivery. This can be explained as majority of patients with proteinuria were delivered at a mean gestation of 33 weeks (far from term). Majority of these were low birth weight with abnormal doppler or oligohydramnios as a complicating factor. Our result was similar in study conducted by Ngwenya S et al, who researched on accuracy of spot protein/creatinine ratio, stated that most of the patients with pre-eclampsia were delivered by cesarean section (78.5%) due to the seriousness of the condition. 13
Show more

8 Read more

Borderline gestational diabetes mellitus and pregnancy outcomes

Borderline gestational diabetes mellitus and pregnancy outcomes

Our study has identified increased risks of maternal adverse health outcomes overall and a range of infant adverse health outcomes associated with BGDM. In Aus- tralia, there are over 250,000 births annually [19]. Our data suggest that a substantial number of Australian preg- nant women, over 20,000 each year, will have BGDM and therefore maternal and infant adverse health outcomes that are directly or indirectly attributable to BGDM. Evi- dence from the Australian Carbohydrate Study in Preg- nant Women (ACHOIS) trial [20] confirmed that untreated mild GDM is associated with relatively rare but nonetheless significant adverse perinatal outcomes. The trial demonstrated that the risk of these outcomes can be reduced with standard treatment consisting of individual dietary and lifestyle advice during pregnancy. There is, however, insufficient evidence regarding the benefits and harms of similar intervention for women with BGDM, with only one small clinical trial identifying a significantly reduced risk of large-for-gestational age infants with die- tary advice and regular blood glucose monitoring for women with borderline glucose intolerance [21]. Data from our analysis highlight the need for well-designed large randomised clinical trials to investigate the benefits and harms of such treatment for women with BGDM. Competing interests
Show more

7 Read more

one step approach for diabetes mellitus in pregnancy

one step approach for diabetes mellitus in pregnancy

IADPSG have included FBS and HbA1C in the first antenatal visit to all women or high risk women only according to the incidence of GDM, the rationale being fasting hyperglycemia supposedly is a more sensitive co-realtor of GDM which was justified by the HAPO guidelines .HAPO study demonstrated an increase in adverse perinatal outcome with elevation of FBS alone on OGTT. The physiological changes which occur during pregnancy the net effect is a lowering of maternal FBS with a sustained significant increase in post-prandial blood sugars. Hence for early and accurate diagnosis definitely FBS will have to be included in the criteria along with the 75gm glucose Post prandial .
Show more

140 Read more

Clinical course and visual outcome in patients with diabetes mellitus and uveitis

Clinical course and visual outcome in patients with diabetes mellitus and uveitis

In a study of over 10,000 patients with DM in the UK the prevalence of diabetic retinopathy has been reported to be 16.5% [16,17]. Our cohort had diabetic retinopathy in 24 patients (66.7%), which is four times higher. The UK Prospective Diabetes Study showed that people with improved glucose control reduced the requirement of laser treatment of the eye by a quarter [18]. Progression of diabetic retinopathy to the proliferative stage over a 4-year follow up in WESDR study in 1075 patients was reported to be 4.7% [19]. In our study 18.4% of patients went on to develop proliferative diabetic retinopathy over an average of 4.36 years. The co-existing uveitis could trigger mechanisms for progression of diabetic retinopathy amongst other factors. However we were unable to identify other main risk factors, such as hypertension and hyperlipidaemia to have a contribu- tory role in our cohort. It was interesting to note rapid progression of non-proliferative diabetic retinopathy to proliferative in one eye of a patient with panuveitis in that eye. There are a number of reports in the litera- ture suggesting either a causative or a protective role of uveitis in relation to proliferative diabetic retinop- athy [20-23]. In the current literature 6 uveitic eyes progressed to PDR in patients with DM whereas two eyes did not progress. This suggests a possible role of worsen- ing diabetic retinopathy in patients with uveitis.
Show more

6 Read more

Correlation of HbA1c levels in late pregnancy with maternal and perinatal outcome in patients with gestational diabetes mellitus

Correlation of HbA1c levels in late pregnancy with maternal and perinatal outcome in patients with gestational diabetes mellitus

This was a prospective study in which 53 pregnant women with Gestational diabetes mellitus were recruited in the study. Approval from the Institutional Ethics Committee was taken. On the basis of 15% abnormal adverse perinatal or pregnancy outcomes among GDM patients, 95% confidence level and 10% permissible error the calculated optimum sample size came out to be 49. Patients with overt diabetes, multiple pregnancy, chronic hypertension, heart disease, liver disease, kidney disease, moderate and severe iron deficiency anemia, fetal congenital anomalies, Thalassemia and GDM diagnosed after 28 weeks of gestation were excluded from the study. HbA1c was measured at 28 - 32 weeks and again at 37 - 39 weeks/at the time of delivery. From each patient 5c.c blood was collected in EDTA vials and HbA1c levels were measured with the help of latex agglutination inhibition assay method. Samples were taken at any time of the day irrespective of fasting status of the patients. Upper reference range of HbA1c that was taken in our study was 5.8%. Pregnancy outcomes were compared in patients with GDM in relation to HbA1c values. Study duration was 18 months.
Show more

7 Read more

OUTCOME OF PREGNANCY AMONG MALAYSIAN WOMEN WITH DIABETES MELLITUS - A SINGLE CENTRE EXPERIENCE

OUTCOME OF PREGNANCY AMONG MALAYSIAN WOMEN WITH DIABETES MELLITUS - A SINGLE CENTRE EXPERIENCE

To observe the maternal and neonatal outcomes among women with diabetes mellitus in pregnancy as compared to healthy control. A case-control study involving 400 women with DM who delivered between 2005 to 2009 was done with age-matched control group. A total of 305 women (76.25%) were gestational diabetes mellitus (GDM) on diet control, 79 (19.75%) were GDM on insulin and 16 (4%) were pre-existing DM. The mean body mass index of the women with diabetes was higher compared to the age-matched healthy women (p <0.001). Approximately one-third of diabetic woman had no antecedent risk factor. About half of the women with diabetes (n=205, 51.3%) had unplanned pregnancy. Women with DM had greater risk of having spontaneous miscarriage and caesarean section (OR 1.4, 95% CI (1.2-1.7), OR 1.3, 95% CI (1.1- 1.5) respectively). Women with diabetes on insulin had higher risk of preterm delivery and caesarean delivery as compared to those with diet control, (OR 1.7, 95% CI (1.2- 2.5), OR 2.5, 95% CI (1.6-4.1) respectively). The incidence of macrosomia, low Apgar score, need for NICU admission, hypoglycaemia and respiratory distress syndrome (RDS) were higher among women with diabetes as compared to healthy control, and especially in those on insulin. Women with higher HbA1c had significantly increased need for caesarean section and NICU admission with higher incidence of macrosomia and RDS. The overall outcome of women with diabetes especially with higher level HbA1c remained poor as compared to a normal pregnancy.
Show more

10 Read more

Show all 10000 documents...