Tayyiba Wasim, Wasim Amer, Ashraf Majrooh.
Feto maternal outcome in pregnant patients with diabetes.
Ann King Edward Med Uni Jan ;21(2):108-12.

Objective: To compare the fetomaternal outcomes in terms of congenital anomalies, miscarriage, macro-somia, polyhydraminos, preterm labor, IUGR, still birth, early neonatal death and operative delivery bet-ween known diabetic and gestational diabetic patients (GDM). The effect of glycemic control on these complications was also studied. Methods: It was a two year comparative analytic study done at Gynae unit III, SIMS, Services Hospital Lahore from Jan 2013 to Dec 2014. Patients were divided into two groups, patients with preexisting type1 or 2 diabetes and those having GDM. Results: A total of 124 patients were found to be diabetic over 2 year study period, out of which 61.3% had gestational diabetes. Family history of diabetes was present in 58% of GDM patients and 42% of known diabetic patients (P > 0.05). 52.6% of GDM patients SIMS / Services Hospital, Lahore had no complication and delivered uneventfully (p < 0.05). Macrosomia was most frequent complication (26.3%) of GDM group and 29% of known diabetic patients. No congenital anomaly and miscarriage occurred in GDM group (P < 0.05). Operative delivery was high 44% in known diabetic patients as compared to 33% of GDM patients but not statistically significant. Perinatal outcome was comparable in both groups. Optimum glycemic control (HbA1c ≤ 6%) was significantly associated with fewer complications p = 0.001. Conclusion: GDM is an increasing health problem and has been associated with fetomaternal complications. Screening is recommended for general pregnant population. Early diagnosis, patient education, proper follow up in close liaison with physician results in better glycemic control and improved maternal and perinatal outcome in diabetic pregnant patients.

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