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Comparison of the outcome of diabetic pregnancy in two district general hospitals
  1. P Maharajan1,
  2. A Ram Mohan2,
  3. K Duckitt2,
  4. F Ashworth3
  1. 1Oxford University Hospital, Oxford, United Kingdom
  2. 2Milton Keynes Hospital NHS Trust, Milton Keynes, United Kingdom
  3. 3Stoke Maneville Hospital, Aylesbury, United Kingdom

Abstract

Introduction Diabetic pregnancy is a high risk pregnancy with increased mortality and morbidity for both the mother and the foetus. Approximately 650,000 women give birth in England and Wales each year, and 2–5% of pregnancies involve women with diabetes.

Aim To compare maternal and neonatal outcome in diabetic pregnancy at the MKGH and SMH, using NICE guidance as the standard.

Method It was a prospective audit over a period of 4 months.

Results Comparison of the results showed that predominantly there were Caucasians with diabetic pregnancy in both hospitals. We had more multiparous women in both hospitals. In SMH we had GDM (71%), Type 1 (20%) and Type 2 (9%). In comparison MKGH had GDM (82%), Type 1 (12%) and Type 2 (6%). Use of combined metformin and Insulin was higher in MKGH (20%) and in SMH was only (6%). Antenatal surveillance in both units in accordance to NICE guidelines were nearly similar. Labour was induced (50%) at MKGH while at SMH was (49%). Outcome of delivery were SVD (40%), Instrumental (7.5%) and LSCS (52%) in MKGH while SVD (46.6%), Instrumental (13.3%) and LSCS (39.9%) at the SMH.

Conclusion In comparison we found induction was noted to be higher and at an earlier gestational age at the MKGH (38wks) when compared to SMH (40wks). Change in policy in accordance to NICE recommendations should be instituted and tailored to each patient's requirements.

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