Abstract :
Background: Gestational Diabetes Mellitus (GDM) is a common pregnancy complication that poses significant risks to both maternal and fetal health. Women with a history of Bad Obstetric History (BOH), defined by recurrent pregnancy losses, preterm deliveries, stillbirths, or previous macrosomic babies, are at an elevated risk of GDM and its associated complications. The present study was undertaken to estimate the prevalence of Gestational Diabetes Mellitus (GDM) in women with Bad Obstetric History (BOH) and to study maternal and fetal outcome after controlling blood sugars to provide insights into better management strategies for these high-risk pregnancies. Methods: In this prospective observational study, 52 pregnant women with BOH and GDM were studied in the Department of Obstetrics and Gynecology, at Lokmanya Tilak Municipal Medical College and Hospital, Mumbai during the period of 18 months from January 2020 to June 2021. Result: The prevalence of Gestational diabetes mellitus (GDM) in women with Bad Obstetric History was 24.18%. The average maternal age at the time of diagnosis was 25.70 ± 06.57 years. The average duration of pregnancy at diagnosis of GDM was 29±4.33weeks. Mean Gestational Age at delivery with SD 37.39 ±1.64. The mean gravidity was 4±0.82. All were multigravidas in this study and had an average body mass index (BMI) of 25.22 ±2.33. The mean blood glucose values were mg/dl at diagnosis. Twenty-two (22) patients (42.30%) were treated with metformin and subcutaneous insulin. Twenty-one (21) patients (40.38%) were treated with Metformin. Eighty women (58%) received subcutaneous insulin, and 9 patients (17.30%) were managed with dietary advice alone. Most common mode of delivery was LSCS- 23 cases (44.24%). Maternal complications observed were polyhydramnios in 17 cases, PROM in 10 cases, preterm delivery in 7 cases, and shoulder dystocia in 3 cases. There were 49 live births and 3 fetal deaths. Thus, maximum patients had good outcome. Conclusion: Hence, treatment of gestational diabetes mellitus (GDM) can improve pregnancy outcome in cases of bad Obstetric history.
Keyword :
Bad obstetric history; Gestational diabetes; Stillbirth