• Saima Yasmin Qadir
  • Tayyaba Yasmin
  • Iffat Fatima


Background: Gestational diabetes is impaired carbohydrate metabolism first diagnosed in pregnancy.Knowledge of diabetes dates back to centuries before Christ. Objective was to describe maternalcomplications during antenatal period and Maternal and neonatal outcome in gestational diabetesmellitus. Methods: This Descriptive observational study was conducted at Department of Obstetricsand Gynaecology, Alhada Military Hospital, Taif, KSA. It was done during January–December 2009 tomeasure maternal and neonatal outcome. Hundred pregnant women diagnosed through glucosetolerance test as diabetic were enrolled as study subjects. All the subjects were enrolled and followedregularly at Obstetric and Gynaecology out-patient Department of Alhada Military Hospital, Taif.Blood glucose level was controlled either by diet or by diet and insulin. Study subjects werehospitalised for adjustment of dose of insulin and for management of complications. Foetal well beingwas assessed by kick count, cardiotocography and ultrasound. Time and mode of delivery was decidedat 36 week of gestation. Intra-partum maternal blood glucose level was monitored and foetalmonitoring was done by cardiotocography. Results: Total numbers of women delivered were 2,858.Hundred cases of diabetes mellitus during pregnancy were studied. Eighty-eight patients were above 25years of age, multiparous ladies with gestational diabetes in 76% of cases. Insulin was required in 64%of patients. Polyhydramnios was most common maternal complication. Two out of 100 hadspontaneous miscarriage; 14 underwent preterm delivery while 84 reached term with two intrauterinedeath. Caesarean section was carried out in 58 patients. Total number of babies delivered alive were 92.There were 4 neonatal deaths. Hyperbilirubinemia was the most common neonatal complication.Conclusion: It was concluded that early detection, constant supervision, strict glycaemic control,delivery with intensive intrapartum monitoring and facilities of expert neonatologist can result in goodmaternal and foetal outcome, without much morbidity.Keywords: Pregnancy, Gestational diabetes mellitus, Maternal outcome, Neonatal outcome


Schneiderman EH. Gestational diabetes: An overview of a growing

health concern for women. J Infus Nurs 2010;33(1):48–54.

Gillmer MDG, Bickerton NJ: Advances in the management of

diabetes in pregnancy: Success through simplicity. In: Bonnar J,

(Ed), Recent Advances in Obstetrics Gynaecology. Edinburgh:

Churchill Livingstone;1994. p. 51–78.

Crowe SM, Mastrobattista JM, Monga M. Oral glucose tolerance

test and the preparatory diet. Am J Obstet Gynecol


Moses RG., Cheung NW. Universal screening for Gestational

Diabetes Mellitus. Diabetes Care 2009;32:71349–51.

O’Sullivan JB. Diabetes mellitus after GDM. Diabetes

;29(Suppl 2):131–5.

O’Sullivan JB, Mahan CM. Criteria for the oral glucose

Tolerance test in pregnancy. Diabetes 1964;13:278–85.

Baqai S, Sultana N, Khan FA. Gestational diabetes in Pakistan:

Experience of screening at military hospital, Rawalpinidi. Pak

Armed Forces Med J 1995;45:43–7.

Riskin-Mashiah S, Younes G, Damti A, Auslender R. First

trimester fasting hyperglycemia and adverse pregnancy

outcomes. Diabetes Care 2009;32(9):1639–43.

Shaukat A, Arain TM, Abid S , Mahmud R. Criteria for

detecting gestational diabetes mellitus. National Diabetes Data

Group Versus World Health Organization. J Coll Physicians

Surg Pak 1999;9(5):211–4.

Gabbe SG. Gestational diabetes mellitus. N Eng J Med


Braveman CT. Evaluating outcomes of pregnancy in diabetic

women. Diabetes Care 1988;281–7.

Al-Shawaf T, Akiel A, Moghraby SAS. Gestational diabetes and

impaired glucose tolerance of pregnancy in Riyadh. Br J Obstet

Gynaecol 1988;95:84–90.

El Shafi AM, Bashmi YA, Beischer NA, Henry OA, Walstab JE.

Incidence and severity of gestational diabetes in Bahrain and

Australia. Aust NZ J Obstet Gynecol 1989;29:204–8.

Hadden DR. Geographic, ethnic and racial variations in the

incidence of gestational diabetes mellitus. Diabetes

;34(Suppl 2):8–12.

Perveen N, Saeed M. Gestational diabetes and pregnancy

outcome: Experience at Shaikh Zayed Hospital. Mother Child


Khan KS, Rizvi JH, Qureshi RN, Mazhar R. Gestational diabetes

in a developing country, University Medical Centre, Karachi. J

Pak Med Assoc 1991;41:31–3.

Anne D, Catherine Williams. Diabetes and endocrine disease in

pregnancy. Edmonds DK. Dewhurst’s Textbook of obstetrics and

gynaecology for postgraduates. 7th ed. Oxford: Blackwell

Science;2007.p. 245–59.

Ang C, Howe D, Lumsden M. Diabetes. In: Jame DK, Steer PJ,

Weiner CP, Gonik B, (Eds). High risk pregnancy management

options. 3rd ed. Philadelphia: WB Saunders; 2006.p. 986–1004.

Usmani AT, Waheed N. Pregnancy complicated with diabetes: A

one year experience. J Pak Inst Med Sci 1995;6:342–5.

Akhtar KAK, Malik MA. Screening for diabetes during

pregnancy. Pak J Obstet Gynecol 1985;1(1):20–4.

Beard RW, Gillmer MDG, Oakley NW, Nithyananthan R,

Cawston M. Screening for diabetes during pregnancy. Br J

Obstet Gynaecol. 1980;87:337–82.

Negrato CA, Jovanovic L, Rafacho A, Tambascia MA, Geloneze

B, Dias A, et al. Association between different levels of

dysglycemia and metabolic syndrome in pregnancy. Diabetol

Metab Syndr 2009;1(1):3.

Randhawa MS, Moin S, Shoaib F. Diabetes mellitus during

pregnancy: a study of fifty cases. Pak J Med Sci


Mark B, Catherine Y Spong, Elizabeth Thom. A multicenter,

randomized trial of treatment for mild Gestational Diabetes. N

Engl J Med 2009;361:1339–48.

Carmody D, Doyle A, Firth RG, Byrne MM, Daly S, Mc Auliffe

F, Teenage pregnancy in type 1 diabetes mellitus. Pediatr

Diabetes 2010;11(2):111–5.

Samad N, Hassan JA, Shera AS, Maqsood A. Gestational

diabetes mellitus-screening in a developing country. J Pak Med

Assoc 1996;46(11):249–52.

Jovanovic-Peterson L. Nutritional management of the obese

pregnant women. Nutr M D 1991;17(6):1–3.

Falls J, Millo L. Endocrine disorders of pregnancy. In: The Johns

Hopkins Manual of Gynecology and Obstetrics. Philadelphia:

Lippincott Williams and Wilkins; 2007.p. 162–75.

Woon KY, Lim LS, Tan KL, Ng C, Yeo PBP, Wes HM, et al.

The infants of a diabetic mother. J Singapore Paed Soc


Mannan J, Bhatti MT, Kamal K. Outcome of pregnancies in

diabetic mothers: A descriptive study. Pak J Obstet Gynaecol


Ferchiou M, Zhioua F, Hadhri N, Hafsia S, Mariah S. Predictive

factors of macrosomia in diabetic pregnancies. Rev Fr Gynecol

Obstet 1994;89(2):73–6.

Peck RW, Price DE, Lang GD, Mac-Vlcur J, Hearnshaw JR.

Birth weight of babies born to mothers with type 1 diabetes: Is it

related to blood glucose control in the first trimester. Diabet Med


Gellis SS, Hsia DYY. The infant of diabetic mothers. Am J Dis

Child 1959;97(1):1–41.

Kitzmiller JL, Cloherty JP, Younger MD, Tabatabaii

A, Rothchild SB, Sosenko I, et al. Diabetic pregnancy perinatal

morbidity. Am J Obstet Gynaecol 1978;131:560–80.