An evaluation in the screening and diagnosis of gestational diabetes mellitus among low and high risk obstetrics population
| dc.contributor.author | Mat Sidek, Asmah Yun | |
| dc.date.accessioned | 2017-08-15T00:59:23Z | |
| dc.date.available | 2017-08-15T00:59:23Z | |
| dc.date.issued | 2001-11 | |
| dc.description.abstract | The study is aimed to determine the prevalence, maternal and fotal outcome of gestational diabetes mellitus among low and high risk hospital base obstetric population using MOGTT WH0-1985 and 1998 criteria. Secondly we aimed to determine the predictive value of three different methods of GDM screening (namely the GCT, potential diabetic picture and fasting plasma glucose). Lastly, we planned to determine the prevalence of persistent diabetes at 6 weeks post-partum among studied GDM patients. A prospective cohort and observational study was conducted from July till November 1999 in an Obstetric Unit Hospital Kuala Terengganu. An antenatal patient between 22 to 36 weeks gestations were divided into two groups depending on presence of clinical risk factors for developing GDM (i.e. low and high risk). GCT was performed upon low risk patients followed by MOGTT one to two weeks later. All patients in high-risk group were given appointment for MOGTT. GCT of 7.2 mmoll/ or more were considered positive. MOGTT results were analysed by using WH0-1985 and 1998 criteria. Those patients with GDM were managed according to hospital protocol. They were followed-up till delivery or admitted at 38 weeks for induction of labour. Babies notes were recorded and lastly, those patients with GDM were given appointment to repeat MOGTT at 6 weeks post-partum. Data were analysed by SPSS version 9. Chi-square and Student t test used to assess the significance. P value of< 0.05 considered significant. Out of 757 women, only 671 completed the study. The prevalence of gestational diabetes mellitus in this studied population is 9.5%(64 out of671) by WHO 1985 and 10.3% (69 out of671) by WH0-1998 (P value <0.05). There were 199low risk patients in which 22 were positive for GCT and 10 of them (6. 0%) were GDM Fifty-four (11.4%) out of 472 high-risk patients were GDM using WH0-1985 and 59(12.5%) by using WH0-1998. Their characteristics are not significantly different. GDM patients were significantly associated with PIH, induced labour and increased risk of caesarean section. Offspring of GDM tend to be heavier and increased incidence to developed macrosomia. No difference in the incidence of premature delivery, stillbirth rates congenital abnormality, shoulder dystocia or prenatal mortality. The incidence of persistent diabetes 6 weeks post-partum is 26.9% in the diabetic picture GDM paitents. The sensitivity for the GCT (Blood sugar > 7.2 mmoVl), single risk factor, multiple riskfactors and the FPG are 90.0%, 68.8%, 76.2%, _14.5% respectively. The specificity for them is 93.6%, 35.6%, 75.9% and 100% respectively. The positive predictive values are 42.8%, 6.0%, 26.9% and 95.0% respectively. The negative predictive values are 99. 4%, 100%, 100% and 91.9% respectively. The prevalence of gestational diabetes mellitus in this studied population is comparable to other local studies. It shows slightly higher when using MOGTI' WH0-1998 compared to WH0-1985 criteria. However there is no difference in all characteristics and outcome measures unless when compared to non-GDM patients. The predictive values of three methods ofGDM screening varied greatly, with the GCT being the best overall. Persistent diabetes 6 weeks post-partum were slightly lower to comparable study probably because poor turn-up for repeat MOG'IT among previously diagnosed as GDM | en_US |
| dc.identifier.uri | http://hdl.handle.net/123456789/4363 | |
| dc.language.iso | en | en_US |
| dc.publisher | Universiti Sains Malaysia | en_US |
| dc.subject | Diabetes | en_US |
| dc.title | An evaluation in the screening and diagnosis of gestational diabetes mellitus among low and high risk obstetrics population | en_US |
| dc.type | Thesis | en_US |
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