ANALYSIS OF CONGENITAL MALFORMATIONS IN OFFSPRINGS BORN TO WOMEN WITH GLUCOSE INTOLERANCE IN PREGNANCY

DR.ANANDHI A; DR.MEENA M; DR.KALAIVANI K

Volume : VII, Issue : IX, September - 2017

ANALYSIS OF CONGENITAL MALFORMATIONS IN OFFSPRINGS BORN TO WOMEN WITH GLUCOSE INTOLERANCE IN PREGNANCY

Dr. Anandhi A, Dr. Meena M, Dr. Kalaivani K

Abstract :

AIM:40 pregnant women with glucose intolerance who gave birth to congenitally malformed babies were studied during and after pregnancy and data with regards to the type of congenital malformations and various degrees of glucose intolerance were analysed.

METHODOLOGY: 40 pregnant women with glucose intolerance who gave birth to congenitally malformed babies were studied with a standard questionnaire.They were categorized into Pre GDM and GDM group. In addition to maternal ,clinical and historical parameters , the initial fasting plasma glucose (derived either from diagnostic GTT or at entry to prenatal care and initial HbA1c before insulin therapy were taken into account and analysed for a correlation to various anomalies.

PLACE OF SUDY – Kasturba Gandhi hospital ,Madras medical college Chennai.

TYPE OF STUDY– Prospective observational study

RESULTS AND ANALYSIS–Among the GDM group , in women who did not have glucose intolerance after delivery the initial mean HbA1c was 5.8%.HbA1C was 7.1% in women who continued to be diabetic after delivery and HbA1C was 6% in the group who had impaired glucose tolerance 6 weeks after delivery. 59% in GDM group and 70% in Pre–GDM had previous pregnancy outcomes such as abortion, IUD and previous congenital anomalies. Among the anomalies, CVS involvement was the most in both the groups.While following up the GDM group to postpartum 13 of the 27 patients (48%) required postpartum insulin. The 17 (not on insulin) patients in the gestational diabetes group were subjected to postpartum 75 gms OGTT, 3 were reclassified as overt diabetes, 6 into impaired glucose tolerance and only 8 of them were normal.

CONCLUSION: It is suggested that in the GDM group exists a subgroup with an increased risk for a diabetic emyopathy, perhaps due to preexisting but undetected Type 2 Diabetes Mellitus. This shows the importance of screening for glucose intolerance early in pregnancy and pre pregnancy counselling for known diabetics who are planning for pregnancy. This study therefore highlights the importance of preconception screening for DM to prevent congenital anomalies occurring during pregnancy.