Pregestational type 1 (T1DM) and type 2 (T2DM) diabetes mellitus and gestational diabetes mellitus (GDM) are associated with increased rates of adverse maternal and neonatal outcomes. Adverse outcomes are more common in women with pregestational diabetes compared to GDM; although, conflicting results have been reported. This systematic review aims to summarise and synthesise studies that have compared adverse pregnancy outcomes in pregnancies complicated by pregestational diabetes and GDM. Three databases, Pubmed, EBSCOhost and Scopus were searched to identify studies that compared adverse outcomes in pregnancies complicated by pregestational T1DM and T2DM, and GDM. A total of 20 studies met the inclusion criteria and are included in this systematic review. Thirteen pregnancy outcomes including caesarean section, preterm birth, congenital anomalies, pre-eclampsia, neonatal hypoglycaemia, macrosomia, neonatal intensive care unit admission, stillbirth, Apgar score, large for gestational age, induction of labour, respiratory distress syndrome and miscarriages were compared. Findings from this review confirm that pregestational diabetes is associated with more frequent pregnancy complications than GDM. Taken together, this review highlights the risks posed by all types of maternal diabetes and the need to improve care and educate women on the importance of maintaining optimal glycaemic control to mitigate these risks.

https://www.mdpi.com/1660-4601/19/17/10846/pdf?version=1661932676

A Systematic Review to Compare Adverse Pregnancy Outcomes in Women with Pregestational Diabetes and Gestational Diabetes

Background: A very common medical condition during pregnancy is Gestational Diabetes Mellitus (GDM) which has become a global health concern, not only for its higher prevalence, but also because it can be a predisposing factor for type 2 DM and causes other increased health risk for both mother and their offspring in later life. Objective: The objective of the study was to compare knowledge of GDM including source of knowledge, treatment, awareness about GDM and impact of GDM on the baby among mothers with GDM and healthy pregnant mothers. Methodology: The study was a cross-sectional study conducted in Cumilla city from May to October 2016. Eighty-nine participants attending the outpatient department of two hospitals and one antenatal clinic in Cumilla city were selected. A structured questionnaire and in-depth interview method was used to obtain data. Result: Significant difference has been found in knowledge between GDM patients and normal pregnant women regarding source of knowledge (p=0.01), treatment of GDM (p=0.000), risk factors of GDM (p=0.01), problems in managing GDM (p=0.003), nutrition maintenance (p=0.006) and physical exercise (p=0.000). No significant difference has been found in GDM awareness (p=0.83) and its impact on the baby (p=0.28) in two groups. Awareness of GDM is found to be associated with higher education (p=0.000), meal plan (p=0.03) and maintaining nutrition (p=0.01). Conclusion: Knowledge about GDM is poor among pregnant women, especially among normal pregnant women. Journal of Science Foundation 2018;16(1):20-26

/pdf/comparison-of-knowledge-of-women-with-gestational-diabetes-31s89ektol.pdf

Comparison of Knowledge of Women with Gestational Diabetes Mellitus and Healthy Pregnant Women Attending at Hospital in Bangladesh

minutes were assessed. Data were analyzed using the student's t-test, chi-square or Fisher's exact test, and multivariate logistic regression. P values less than 0.05 were considered statistically significant. Results: There were no significant differences between the two groups in terms of baseline characteristics. There was a significant difference between the ASA and placebo groups in the incidence of preeclampsia (2.5% versus 22.5%), adjusting for the neonatal and maternal covariates. Conclusions: ASA prophylaxis can be used for prevention of preeclampsia in high-risk patients with abnormal uterine artery.

Aspirin and preeclampsia prevention in patients with abnormal uterine artery blood flow

Evaluation of knowledge regarding gestational diabetes mellitus: a Bangladeshi study

Background: Gestational diabetes mellitus is associated with increased risk of serious perinatal morbidities and mortalities, as well as maternal morbidities. The objective of this study was to compare the maternal and fetal outcome of gestational diabetes mellitus with healthy pregnant women. Material & Methods: This study was carried out in Khyber Teaching Hospital, Peshawar, Pakistan. One hundred and thirty ladies with gestational diabetes mellitus and 97 healthy pregnant women were registered and followed until delivery to know the maternal and fetal outcome. Results: Adverse maternal outcomes like pregnancy induced hypertension (p=0.02), pre-eclampsia (p=0.02), premature ruptures of membranes (p=0.002), preterm labors (p=0.001), and cesarean sections (p=0.009) were significantly higher in GDM as compared to HPW. Neonates of GDM women had increased incidence of macrosomia (p=0.001), birth trauma (p<0.001) and jaundice (p=0.001). Conclusion: Adverse maternal and fetal outcomes of gestational diabetes are significantly higher in gestational diabetes mellitus as compared to healthy pregnant women.

Maternal and fetal outcome of gestational diabetes mellitus

Introduction: Preeclampsia is a serious complication of pregnancy and common cause of fetal and maternal morbidity as well as mortality worldwide. In diabetic women, the chance of preeclampsia is increased. The incidence of preeclampsia in diabetic pregnancy is approximately 10 to 15 percent, which is associated with poor glycaemic control. Aim: This study was carried out to find the predisposing factors related to preeclampsia and determine the complications of preeclampsia in diabetic pregnancy and also the impact of preeclampsia in infants born to diabetic mothers. Methods: This prospective study was carried out at the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka. The Patient population consisted of 80 diabetic pregnant women who attended or admitted to BIRDEM hospital during the study period. The women were divided into groups: 50 pregnant diabetic women with preeclampsia were taken as case. 30 pregnant diabetic women without preeclampsia were taken as control. Diagnosis of preeclampsia was made on the basis of the criteria of the Committee on Terminology of the American College of Obstetrician and Gynecologist. Results: Preterm delivery (<37 weeks gestation) was higher among study group (64%) compared to control (33.3%) women. Term delivery was 36.0 vs 66.7 percent among case and control women, respectively. The distribution is statistically significant (P<0.01). 35 percent of Caesarean section was done due to fetal distress in the study group and in control group it was 20 percent. In study group, 22.5 percent Caesarean sections were done due to impending eclampsia and eclampsia, 705 percent due to accidental haemorrhage and 5 percent due to IUGR. Maternal complication in study and control subjects. In the case group, maximum number of the women (16%) showed signs of impending eclampsia, while among control women, maximum number (10%) developed postpartum haemorrhage (PPH). 48 percent neonates were of low birth weight and in controls it was 13.3 percent. Both hyperbilirubinaemia (40%) and hypoglycaemia (30%) were more in study group than controls (16.66% and 20%, respectively). Perinatal outcome among study group and controls. Neonatal survival was 82.0 percent in study group and 86.7 percent in control group. Comparison of Perinatal outcome between the groups is not statistically significant. Most of the perinatal mortality was due to prematurity (8%) and intrauterine death (6%). In control group, most of the perinatal deaths were due to congenital anomalies (6.6%). Conclusion: The higher incidence among study group may be, in part, the result of more preterm birth or shortened gestational duration because early delivery is a consequence of preeclampsia. The higher rate in associated with preeclampsia was due to increased incidence of IUD and prematurity. DOI: http://dx.doi.org/10.3329/birdem.v1i1.12379 Birdem Med J 2011; 1(1): 10-14

/pdf/the-incidence-predisposing-factors-complications-and-outcome-36af9chq0m.pdf

The Incidence, Predisposing Factors, Complications and Outcome of Preeclampsia in Diabetic Pregnancy

Objective: The aim of the study is to describe the tuboperitoneal findings in selected infertile patients by laparoscopy. Methods and Materials: This cross-sectional study was carried out at the infertility center in BIRDEM during the period of September 2002 to February 2003. A total of 50 patients were selected for laparoscopy and dye test. Those patients who had medical disorder and contraindications for laparoscopy were excluded from the study. Patients with infertility due to male factors were also excluded from this study. Laparoscopy was scheduled in secretory phase of menstruation. Results: Among the study population, 35 (70%) patients were primary infertile group while 15 (30%) patients were secondary infertile group. According to age distribution, 20 (57%) patients of primary infertility and 8 (53%) patients of secondary infertility belonged to age group 25-30 years. Duration of infertility was between 2 yrs to 5 yrs in 45% of patient where 30% cases had been infertile for 5 yrs to 10 yrs. Laparoscopy revealed normal findings in 14 (28%) patients and ovarian cause like chocolate cyst and polycystic ovary in 21 (42%). Peritoneal pathology like adhesion or endometriosis was detected in 19 (38%) cases. Bilateral tubal occlusion was found in 4 (8%) cases and unilateral tubal occlusion in 7 (14%) cases. Conclusion: Laparoscopy is a necessary diagnostic tool for evaluation of tubo-peritoneal pathology in infertile women. DOI: http://dx.doi.org/10.3329/birdem.v4i1.18546 Birdem Med J 2014; 4(1): 9-12

Laparoscopic Evaluation of the Tuboperitoneal Factors in Infertility

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The Incidence, Predisposing Factors, Complications and Outcome of Preeclampsia in Diabetic Pregnancy

Laparoscopic Evaluation of the Tuboperitoneal Factors in Infertility