Screening of Gestational Diabetes Mellitus Screening with 75gm OGTT and Feto-maternal Outcome

Abstract

Our study was designed to find out the incidence of Gestational Diabetes Mellitus by
using 75 gm oral glucose tolerance test as a single step procedure to both screen and
diagnose and to know the effects of gestational diabetes towards maternal and fetal
outcome. 500 pregnant women with singleton pregnancy were screened with 75 gm
oral glucose tolerance test. Those with 2 hour venous plasma glucose of >140mg/dl
were diagnosed as gestational diabetes and were put under medical nutrition therapy
or insulin. All the cases were followed up till delivery for fetal and maternal
outcome. The overall incidence of gestational diabetes mellitus was 5.2%. It was
more common in obese patients, with family history of diabetes and in multigravidas.
Maternal complications like vaginal candidiasis, hypertension, polyhydramnios, and
preterm labour were more common in diabetic group. Fetal outcomes like
macrosomia, shoulder dystocia, still birth, hypoglycemia, congenital anomalies,
trauma during delivery were all found to be more in patients with gestational diabetes.
The rise in prevalence of Gestational Diabetes in our community and its associated
increased risk of pregnancy and delivery complications justifies a need to screen
pregnant mothers who attend the antenatal clinic. This single step procedure (75gm
OGTT) is a simple economic and feasible method. It serves both for the purpose of
screening and diagnosis at the same time.