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T. Ua-areechit, K. Supakosol, K. Tengtrisorn, 5 th year medical student

Maternal and neonatal outcomes in patients with gestational diabetes mellitus in Naresuan University Hospital. T. Ua-areechit, K. Supakosol, K. Tengtrisorn, 5 th year medical student Advisors: P. Amatyakul, M.D., S. Sritippayawan, M.D. Obstetrics and Gynecologics department

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T. Ua-areechit, K. Supakosol, K. Tengtrisorn, 5 th year medical student

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  1. Maternal and neonatal outcomes in patients with gestational diabetes mellitus in Naresuan University Hospital T. Ua-areechit, K. Supakosol, K. Tengtrisorn, 5th year medical student Advisors: P. Amatyakul, M.D., S. Sritippayawan, M.D. Obstetrics and Gynecologics department Faculty of medicine, Naresuan university hospital, Phitsanulok, Thailand

  2. Backgound • Objective • Materials and Methods • Results and Discussion • Conclusions Outline

  3. BACKGROUND

  4. Background • Gestational diabetes mellitus is carbohydrate intolerance with onset or first recognition during pregnancy. • About 1-14 percent of pregnancy develops this condition depend on the nation2 • In thailand, from faculty of medicine, Mahidol University in 2550 found that the incidence of GDM about 2-3%

  5. Background • GDM is linked to several maternal and fetal complications and has morbidity and mortality. 5-8 • GDM is one of the most common pregnancy complications that affects as many as 5% of all pregnancy women.9 • Maternal complications : Increase rate of cesarean section, Postpartum hemorrhage, Pregnancy induced hypertension, Preterm labor, Polyhydramnios. 5-8 • Fetal complications : Macrosomia, Large-for-gestational age (LGA), Respiratory distress syndrome, Hypoglycemia, Hyperbilirubinemia, Polycythemia, Low APGAR score. 5-8

  6. Background GDM frequently resolves after delivery but 1/3 cases will have diabetes or impaired glucose metabolism at postpartum screening and 15-50% will develop diabetes in the decades following the pregnancy making it one of the most common health problems in pregnancy. Therefore, the data collection on the pregnancy outcomes in Naresuan University Hospital should be made

  7. OBJECTIVE

  8. Objective To determine maternal and neonatal outcomes in patients with GDM in Naresuan University Hospital comparing with non-diabetic pregnancy clients.

  9. MATERIALS AND METHODS

  10. Materials and Methods Retrospective cross sectional study Maternal General characteristics Fetal GDM pregnancy woman Pregnancy outcome Maternal Fetal Data collecting From medical records regarding baseline characteristics, maternal and neonatal outcomes, route of delivery, glycemic control and diabetic management.

  11. Materials and Methods Study population • Subject group • Inclusion criteria GDM who delivered at Naresuan University Hospital during June 1, 1999, to May 31, 2012 • Exclusion criteria Overt DM

  12. Materials and Methods • Control group • Inclusion criteria Non-diabetic women who delivered during June 1, 1999, to May 31, 2012 by using Systematic Random Sampling • Exclusion criteria History of DM, GDM, congenital anomalies related to DM

  13. RESULTSANDDISCUSSION

  14. Figure 1. Demographic comparison of patient with GDM and a control group without GDM

  15. Figure 2. Comparison of maternal outcomes in patients with GDM and a control group without GDM 24 cases 40.68% ★ ★ Significant 11 cases 18.64% 9 cases 15.25% ★ ★ Premature contraction GHT primary C/S PPH (Tear)

  16. Figure 3. Comparison of fetal outcomes in patients with GDM and a control group without GDM ★ 21 cases 35.49% 17 cases 28.81% 12 cases 20.34% ★ ★ ★ Significant 16

  17. Figure 4. Maternal and fetal outcome among women with GDM well controlled and poorly controlled GDM LGA LOS Hypoglycemia

  18. CONCLUSIONS

  19. Neonatal • Hypoglycemia • LGA • NICU Poor control Well control Conclusion Treatment • -Preterm • Macrosomia • Hypoglycemia Maternal and fetal outcome GDM Pregnancy • Maternal • Primary C/S • Preterm • GHT

  20. References 1. National Diabetes Data Group Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance Diabetes 1979; 28: 1039-57. 2. Hadden DR Geogrphic, ethnic, and racial variations in the incidence of gestational diabetes mellitus Diabetes 1985; 34 (suppl 2): 8-12. 3. Hunt KJ,Schuller KL. The increasing prevalence of diabetes in pregnancy. Obstet Gynecol Clin North Am 2007; 34:173-99,vii 4. Serirt S, Derrochanawong C, Sunthornthepvarakul T, Jinayon P Gestational diabetes mellitus J Med Assoc Thai 1992; 75: 315-8. 5. Cunnungham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III, Wenstrom KD, Diabetes. Williams Obstetrics. 22nd ed. New York: McGraw-Hill; 2005: 1169-84

  21. Thank you for your attention

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