CORRELATION BETWEEN AMNIOTIC FLUID VOLUME, MATERNAL GLUCOSE LEVELS, NEONATAL BIRTH WEIGHT IN PREGNANCY COMPLICATED WITH GESTATIONAL DIABETES MELLITUS, GESTATIONAL IMPAIRED GLUCOSE TOLERANCE, NORMAL PREGNANT MOTHERS AND PERINATAL OUTCOME

*Dr. A. Vaseela Banu, MBBS, DGO, MS. OG. and Dr. T. Rosalind, MBBS, DGO, MS. OG.

ABSTRACT

Introduction: Pregnancies complicated by diabetes are frequently characterized by an increased volume of amniotic fluid, and the pathophysiologic mechanism of this increase is not known. Our goal was to evaluate the relationship between maternal blood glucose levels and the amniotic fluid volume in pregnancies complicated by gestational diabetes or impaired glucose tolerance and to compare it with that seen in normal pregnancies. Methodology: This study was done as a prospective Cohort study for period of eighteen months, about 200 pregnant women attending Antenatal clinic in Tirunelveli medical college & hospital from around Tirunelveli district in period of 18 months was studied. Pregnant women with singleton gestation, and gestational age of >20weeks, who found to have gestational diabetes mellitus, gestational impaired glucose tolerance and age ≥ 18 years were included in the study. They were divided into three groups, Gestational diabetes mellitus, gestational impaired glucose tolerance, and normal pregnancy according to the result of glucose tolerance test (GTT), All women will have GTT at 24-28weeks, when they have positive GTT, they will be required to have Amniotic fluid volume at 36 weeks, maternal fasting blood glucose levels, and they will be followed till to delivery and neonatal birth weight will be correlated to study the relationship between these indices. Statistical analysis of linear regression will be done on these indices, Also delivery and perinatal outcome in terms of neonatal morbidities are also studied. Results: The mean amniotic fluid volume was significantly increased in the diabetes group. The blood glucose concentration was also significantly greater in the diabetes group than in the control group. The mean fasting blood glucose concentration among the women with diabetes was also significantly. Conclusion: Pregnancy complicated with Diabetes mellitus carries significant risks for both mothers and infants, since outcome of such pregnancy remains substantially worse than that of general gestational population. GDM, uncontrolled hyperglycaemia will increases the risk of preeclampsia, ceaserean delivery, future type 2 diabetes, in the mothers while In fetus or neonates, it is associated with higher rates of perinatal morbidity, macrosomia, respiratory distress, neonatal hypoglycaemia. Various studies confirmed on the importance of treatment and perinatal care of diabetic mother to ensure optimal control of their blood glucose levels in order to lower severe perinatal outcomes among infants.

Keywords: Gestational diabetes, impaired glucose tolerance, pregnancy.