Objective To determine the maternal and fetal outcomes in mothers with gestational diabetes in a District general hospital.
Design Retrospective study.137 patients with GDM were selected randomly.
Results 53% were controlled with diet alone. 67% of which went into spontaneous labour. 19% were induced mainly for other reasons apart from GDM, of which 50% were induced between 37-40 weeks and 43% at >40 weeks. 64% underwent a SVD. 14% had ELCS between 37-40 weeks. The mean birth weight was 3.34kg.
34% were treated with metformin. 43% went into spontaneous labour, 36% were induced and 21% had ELCS. The majority 71% were induced between 37-40. 40% of these women had a SVD. All elective caesarean sections occurred after 37 weeks. The mean birth weight was 3.37kg.
Only 7% of our patients treated with both metformin and insulin and 6% with insulin alone. 44% needed induction and 39% had ELCS between 37-40 weeks. The mean birth weight of those on metformin and insulin was 3.56kg and 3.59 for those on insulin.
There was only 1 case of shoulder dystocia with a birth weight of 2.94kg.
Only 4% of neonates required admission to NICU.
Conclusion The mean birth weight increases when patients on treatment with metformin and insulin compared to diet only.
in cases of well controlled GDM on diet, there is no justification for actions different from those of normal pregnancy.
GDM on metformin or insulin are more likely to have intervention at <40 weeks to avoid the risk of macrosomia.
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