Medicinos teorija ir praktika 2016 m. 22 tomas Nr. 5
ANALYSIS OF CARE, MATERNAL AND NEONATAL OUTCOMES IN SUBJECTS WITH GESTATIONAL DIABETES MELLITUS
Živilė Bukelskienė, Gintarė Naskauskienė, Diana Ramašauskaitė, Žydrūnė Visockienė
Correspondence Address: email@example.com
Key words. Gestational diabetes mellitus, glucose tolerance test.
Objective. To evaluate the medical care of women diagnosed with gestational diabetes (GD) mellitus, as well as maternal and neonatal outcomes.
Methods. Retrospective data of women diagnosed with gestational diabetes mellitus who delivered at Vilnius University Hospital Santariskiu Klinikos during the period of 01.01.2015–31.12.2015 were collected from electronic database. Information on gestational diabetes risk factors, maternal and neonatal outcomes was recorded.
Results. Retrospective analysis of 205 cases was performed. Patients were 31.8 ± 4.6 years of age, with average body mass index before pregnancy – 26.5 ± 5.4 kg/m2. Up to 29 week of gestation gestational diabetes was diagnosed in 35.2 % of cases. Subjects having their second and further labour ended with macrosomic newborn in 32 (33.3 %) cases. Woman in second
or further pregnancy, previously had miscarriage in 36 (30.5 %), gestational diabetes– in 11 (10.1 %) cases. Family history of diabetes mellitus had 88 (47.8 %) women. No gestational diabetes risk factors were estimated in 49 (23.9 %), one – in 87 (42.4 %), two – in 44 (24.5 %), three – in 15 (7.3 %) –and four or more – in 10 (4.9 %) woman. Average duration of pregnancy was 38.7 ± 1.9 weeks. Cesarean section was performed in 65 (31.7 %) cases. Average newborn weight was 3581.2 ± 630.2 g. Gestational hypertension/preeclampsia was diagnosed in 22 (10.7 %) cases, 19 (9.3 %) pregnancies ended in preterm birth and 13 (6.3 %) were complicated with polyhydramnios. Macrosomia was diagnosed in 52 (25.4 %), birth injury – in 7 (3.4 %), hyperbilirubinemia – in 10 (4.9 %), congenital malformations – in 9 (4.4 %), hypoglycemia – in 6
(2.9 %) newborns.
Conclusion. Gestational diabetes was diagnosed on time only in one quarter of subjects. More than three quarters of women with GD had at least one risk factor, one fourth – complicated pregnancy, almost half of babies – newborn complications. These results clearly higlights the need of guidelines for care during pregnancy.
September 12, 2016 Accepted:
November 25, 2016