Serrano BMÁ

Language: Spanish
References: 13
Page: 287-291
PDF size: 334.97 Kb.

ABSTRACT

Background: Gestational diabetes mellitus is a disorder of carbohydrate metabolism of varying severity that begins or is first recognized during pregnancy, regardless of insulin required control or persistence after termination of pregnancy.
Objectives: To determine the incidence of gestational diabetes and to identify risk factors in patients attending the Regional Hospital Adolfo Lopez Mateos.
Patients and method: A prospective, cross-sectional, observational and descriptive study that included 63 patients who consulted for the first time in emergency obstetric maternity between weeks 11-35 of gestation. We studied 58 pregnant patients between 24 to 28 weeks of gestation; patients were submitted to clinical history, metabolic screening and curve tolerance glucose (CTG) in cases where it was required.
Results: We excluded five patients who did not meet the established gestational age range. Maternal age had a mean of 30.7 ± 5.9 years, with an average pregnancy number of 2.6, within average of 25.6 weeks of gestation. The 63.8% of patients reported a family history of diabetes mellitus 2 and 12.1% smoking history, as the previous product weight, 54.7% were in the range of 2,800-3,800 g, and only in 5.1% was greater than 3,800 g. Regarding obstetric risk 77.6% had not history of importance and remaining 22.4% had a history of preeclampsia, hypertension, hypertensive disease of pregnancy, molar pregnancy, abortion, cholelithiasis, polyhydramnios, premature rupture of membranes and neonatal death. Body mass index of 51.7% was found in the range of 19.9 to 26, being within normal standards, and 48.2% were within the range greater than 26.1 presenting with an increased risk for developing gestational diabetes. Of the 58 studied patients, 25.9% were diagnosed as gestational diabetes, 5.2% as carbohydrate intolerant and 69% unchanged. In 15.3% of the patients the diagnosis was made by metabolic screening and for 9.4% was performed by curve intolerance glucose (CTG).
Conclusions: Test of O’Sullivan should be included in prenatal testing of all pregnancy patients within 24 to 28 weeks of gestation.

REFERENCES

1. Vidaeff A, Yeomans E, Ramin S. Gestational diabetes: A field of controversy. Obstet Gynecol Survey 2003;58:759-769.

2. Stuart A, Amer-Wåhlin I, Persson J, Källen K. Long-term cardiovascular risk in relation to birth weight and exposure to maternal diabetes mellitus. Int J Cardiol 2013;168:2653-2657.

3. Mordwinkin NM, Ouzounian JG, Yedigarova L, Montoro MN, et al. Alteration of endothelial function markers in women with gestational diabetes and their fetuses. J Matern Fetal Neonatal Med 2013;26:507-512.

4. Veeraswamy S, Vijayam B, Gupta VK, Kapur A. Gestational diabetes: the public health relevance and approach. Diabetes Res Clin Pract 2012;97:350-358.

5. Nilofer AR, Raju VS, Dakshayini BR, Zaki SA. Screening in high-risk group of gestational diabetes mellitus with its maternal and fetal outcomes. Indian J Endocrinol Metab 2012;16:74-78.

6. Palomba S, Falbo A, Russo T, Rivoli L, et al. The risk of a persistent glucose metabolism impairment after gestational diabetes mellitus is increased in patients with polycystic ovary syndrome. Diabetes Care 2012;35:861-867.

7. Kanda E, Matsuda Y, Makino Y, Matsui H. Risk factors associated with altered fetal growth in patients with pregestational diabetes mellitus. J Matern Fetal Neonatal Med 2012;25:1390-1394.

8. Rudge MV, Lima CP, Damasceno DC, Sinzato YK, et al. Histopathological placental lesions in mild gestational hyperglycemic and diabetic women. Diabetol Metab Syndr 2011;3:19.

9. Ismail NA, Aris NM, Mahdy ZA, Ahmad S. Gestational diabetes mellitus in primigravidae: a mild disease. Acta Médica (Hradec Kralove). 2011;54:21-24.

10. Maple-Brown L, Ye C, Hanley AJ, Connelly PW, et al. Maternal pregravid weight is the primary determinant of serum leptin and its metabolic associations in pregnancy, irrespective of gestational glucose tolerance status. J Clin Endocrinol Metab 2012;97:4148-4155.

11. Malinowska-Polubiec A, Sienko J, Lewandowski Z, Czajkowski K, et al. Risk factors of abnormal carbohydrate metabolism after pregnancy complicated by gestational diabetes mellitus. Gynecol Endocrinol 2012;28:360-364.

12. Black MH, Watanabe RM, Trigo E, Takayanagi M. High-fat diet is associated with obesity-mediated insulin resistance and β-cell dysfunction in Mexican Americans. J Nutr 2013;143:479-485.

13. Goldberg RJ, Ye C, Sermer M, Connelly PW, et al. Circadian variation in the response to the glucose challenge test in pregnancy: implications for screening for gestational diabetes mellitus. Diabetes Care 2012;35:1578-1584.