Prevalence and diagnosis of gestational diabetes mellitus (gdm) and fetomaternal outcome in women with gdm

Objective: the study was conducted to diagnose the gestational diabetes mellitus (GDM) in early pregnancy using glucose challenge test (GCT) and glucose tolerance test (GTT) and to find out the prevalence of GDM in southern part of Rajasthan and fetomaternal outcome in those GDM patients.
Material and Methods: It was a prospective study carried out in the department of Gynaecology and Obstetrics of a tertiary healthcare centre during the period of 2 years from January 2017 to January 2019. 700 random pregnant women with 18-28 week of gestation were subjected to 50 gram GCT. Women with abnormal GCT were then subjected to 75 gram 2 hour GTT test. Patients were followed up till delivery and perinatal and maternal status were recorded.
Results: The age of the study participants ranges from 18 to 36 years with the mean age of 24±3 years while the mean age of GDM diagnosed women was 28.3±2 years. Out of 700 pregnant women included in the study, 67 women were found to have abnormal GCT and 27 women (3.8%) out of these 67 were found to have abnormal OGTT and were diagnosed with GDM. Most of the GDM patients were having plasma glucose level between 166-175mg/dl (33.33%) followed by 155—165mg/dl (29.62%). There was no fetal loss, no congenital abnormalities; no birth asphyxia in any of the newborns of GDM diagnosed women. 4 out of 27 newborns had macrosomia (weight >4kgs) and 3 newborns had IUGR (weight < 2.5kgs). Mean birth weight was 2.67 kgs.
Conclusion: prevalence of GDM in present study was 3.8%. Routine screening of pregnant women before 28 week of gestation with GCT and GTT should be performed because it is an easy, economical and patient friendly test. Prompt diagnosis and early management can improve maternal and perinatal outcome.