European Journal of Molecular & Clinical Medicine

Gestational diabetes mellitus has emerged as a global public health problem with an exceptionally high estimated prevalence.The addition of biomarkers to predictive models of GDM may improve the ability to identify women at risk of GDM prior to its development.SETTING: SCB Medical College, Cuttack, Odisha, India

Background: The present study was conducted for assessing glycemic status of gestational diabetic women on anti-hyperglycemic medication and neonatal outcome of their off spring.
Materials & methods: Total subjects enrolled in the present study were 50. Out of these 50 subjects, 25 subjects were treated with Insulin while the remaining 25 were managed with Metformin. The study subjects were followed up until delivery and details regarding fetal outcome like birth weight, blood sugar level etc were recorded assessed. All the results were recorded and analysed using SPSS software.
Results: Mean HbA1c levels post treatment among patients of metformin group and insulin group was 5.9% and 5.1% respectively. Although non-significant, mean HbA1c levels were slightly better among patients of the insulin group. Metformin was found to cause less neonatal complications when compared to that of the insulin treatment group.
Conclusion: Metformin wasfound as slightly more effective as Insulin in the management of GDM.

One of the most typical pregnancy issues is gestational diabetes mellitus, which has detrimental short- and long-term implications on the health of both the mother and the foetus. Women who are expecting should be aware of the advantages of prenatal exercise. They ought to be excited about the prenatal exercises.
Objectives:
1. To assess the knowledge of antenatal mothers regarding effect of exercise on gestational diabetes mellitus.
2. To determine the association between knowledge of antenatal mothers with selected demographic variables.
Methods:
The sample for the investigation was chosen using the practical sampling technique. A structured knowledge questionnaire with three sections was used to collect the data. The respondent's socio-demographic information is in the first part. The second portion covers mothers' knowledge about exercise. Using descriptive and inferential statistics, the data was examined.
Results:
More than half (44%) of the respondents fell between the age range of 24-28 years, and 34% had completed primary school. 50 percent of mothers had a status as a housewife as their occupation. Nuclear families made up 50% of all families, while joint families made up 24%. Mothers made more than $10,000 per month (48%) and between $5,000 and $7,000 (22%) for their families. reveals that 34% of mothers had inadequate understanding of exercise whereas 66% of mothers had strong knowledge. Pregnant women practicing prenatal exercise received the highest area-wise mean and SD scores for relaxation (64 25.4) and breathing exercises (52.7 12.6). Mother’s educational status in multivariable logistic regression analysis, Place of residence and family monthly income were the factors that significantly associated with the exercise so p<0.005.
Conclusion:
The majority of pregnant women with gestational diabetes had exercise knowledge considerably below the bare minimum anticipated. Gestational mother required proper knowledge regarding exercise.
Antenatal Mothers, Exercise, Gestational diabetes mellitus, Antenatal services

Introduction: The two most prevalent endocrine conditions that can be seen during pregnancy are thyroid dysfunction and gestational diabetes (GDM). Changes in glucose metabolism and insulin resistance (IR) can both be linked to abnormalities in thyroid function. The study's objective was to ascertain whether pregnant women with gestational diabetes have aberrant thyroid hormone levels.
Material and methods: The medical files of 662 pregnant women who gave birth between 2020 and 2022, separated into two groups: 412 with GDM and 250 with normal glucose tolerance. Using the International Federation of Gynecology and Obstetrics (FIGO) and American Diabetes Association (ADA) standards, a 2-h, 75-g oral glucose tolerance test (OGTT) was used to determine the presence of gestational diabetes mellitus in the study group. TSH, free thyroxine, free triiodothyronine, the FT3:FT4 ratio, fasting plasma glucose, age, and body mass index were all examined in both groups' mean blood concentrations. The Mann-Whitney U-test was used to compare the two groups.
Results: Significantly greater TSH and FT3 concentrations (p 0.0001), lower FT4 concentrations (p 0.0001), and higher FT3:FT4 ratios (p 0.0001) were reported in patients who acquired GDM.
Conclusion: According to the findings of this pilot retrospective series, high-normal to high TSH levels, low-normal to low FT4 levels, and a high FT3:Ft4 ratio may all point to an increased risk of developing GDM.

Background: It has long been believed that a lack of vitamin D increases the likelihood of developing glucose intolerance. During pregnancy, pregnant women with gestational diabetes mellitus (GDM), impaired glucose tolerance (IGT), and non-GDM control participants were all compared for their serum levels of 25-hydroxy vitamin D3.
Methods: In this case-control study, 111 non-GDM control women were compared to 54 women with diagnosed GDM, 39 women with IGT (1 abnormal oral glucose tolerance test), and 54 women without GDM. In terms of gestational age, age, and body mass index, controls and the IGT and GDM groups were matched.
Results: When compared to non-GDM controls, the maternal blood 25-hydroxy vitamin D3 concentration in the GDM and IGT groups at 24-28 weeks of gestation was considerably lower (P =.001). Plasma 25-hydroxy vitamin D3 concentrations were consistent with a diagnosis of vitamin D insufficiency in 83.3% of GDM and 71.2% of the control group (P =.03). When compared to the control group, women with GDM had a 2.66-fold higher probability of being deficient (25-hydroxy vitamin D3 15 ng/mL).
Conclusions: According to these findings, vitamin D deficiency is more common in women with IGT/GDM, and more research is needed to determine how vitamin D status affects a woman's ability to tolerate glucose during pregnancy.

Background: Gestational Diabetes Mellitus is defined as glucose intolerance of variable severity or hyperglycemia occurring for the first-time during pregnancy but the glucose intolerance reverting back to normal after the puerperium. GDM is one of the leading causes of mortality and morbidity for both the mother and the infant worldwide. Previous history of GDM, antenatal depression, family history of diabetes, low physical activity, overweight and/or obese women and inadequate dietary diversity might be the factors associated with GDM.

Introduction: Gestational diabetes mellitus (GDM) is the most common medical complication and metabolic disorder of pregnancy. The aim and objective of this study were to determine the prevalence of GDM and its relationship with various risk factors.
Material & Method - Cross-sectional Descriptive study was conducted in a selected tertiary care Hospital, Bhubaneswar,Odisha, India. The tool used was a self-structured questionnaire. The study was done on 289 antenatal mothers of any gestation age, attending an antenatal outpatient department in a tertiary care hospital of KIMS, PBMH, Hospital Bhubaneswar.  These antenatal mothers were given 75gm oral glucose irrespective of the last meal and their plasma glucose was estimated at 2 hours. Antenatal mothers with plasma glucose values ≥140 mg/dl were labeled as GDM. Antenatal mothers who were diabetic before pregnancy or who had chronic diseases like tuberculosis, malignancy, renal failure, cardiac disorder, and mothers with twin pregnancies were not included in the study. The sampling technique used was the consecutive sampling technique among all study samples it was assessed by using chi-square, P value statistical analysis, and analysis was done by the use of SPSS software version 20 and Microsoft Excel, 2007.
Results: The study shows that the prevalence of GDM was 29.7% and the risk factors are 90.70% of antenatal mothers were taking 4-5 times meals per day during pregnancy,98. 84 % of mothers were under BMI 25 to 29.9, 52.33% of mothers were moderate workers, Diabetes Mellitus was present34.88%  in family history, Amniotic fluid 1000-1500 ml was present in 56.98% of mothers,84.88%  non-veg diet.
Conclusion: In this study, the GDM prevalence rate was 29.7%. It is a medical associated disorder during pregnancy. GDM has detrimental effects on the mother as well as the fetus. Hence screening and early detection are highly recommended, and close monitoring of blood glucose levels has shown to significantly reduce fetomaternal morbidity and mortality rate

Aim of study: To study Clinically Maternal and Perinatal Outcome in Gestational Diabetes Mellitus at a Tertiary Care Centre.
Material & Methods: A Prospective observational study was conducted inthe labour room , Depatment of Obstetrics and Gynecology at a  tertiary care hospital , during 1^st October 2019 to 30^th September 2021. In this study we enrolled 120 cases during two years. All pregnant women diagnosed as GDM and delivering in our hospital were included.
Observation & Results: 47(39.17%) pregnantwomen with GDM were from age-group of 21-25 years. Majority of the cases of GDM i.e.34(28.3%) were associated withDiabetes in first degree relatives. Most frequent antepartum maternal complication seen was pre-term found in 32 (26.7%). In intrapartum, 3(2.5%) pregnant women were foundto have Cervical Tear and postpartum, Post operative wound infection (Purpural Sepsis) was observed in 3(2.5%)  pregnant women and 07(5.8%) had Postpartum hemorrhage. Most frequent maternal complication in  pregnant women with GDMwhich was observed wasPreterm labour i.e. 32(26.7%). Among foetal complications , maximum i.e.  in 11(9,2%) GDM pregnant women, Intrauterine foetal death was observed and 02(1.7%) were IUGR and 01(0.83) reported Shoulder Dystocia. 14(11.7%) pregnant women reported perinatal mortality.
Conclusion: Screening for GDM should be done at the first antenatal visit. Precise control of blood sugar right from the beginning of pregnancy assures a good maternal and neonatal outcome. Gestational Diabetes Mellitus is a high risk pregnancy and should be delivered at a tertiary care centre or a centre equipped with all the facilities needed.

Background: Obesity is one such pre-existing maternal morbidity that puts a pregnancy at risk. Maternal obesity is a frequent high-risk factor with substantial prenatal, intranasally, and postnatal problems. This study aimed to analyze maternal and fetal outcome in obese pregnant women (BMI more than 30) at our tertiary care teaching hospital.
Material and Methods: This study was prospective & observational study, conducted in pregnant women, gestational age > 28 weeks, with BMI > 30, delivering at our labour room. Maternal and neonatal outcomes were analysed.
Results: Among 453 pregnant women with BMI > 30kg/m², majority were from 19—25 years age group (45.1 %), 48.03% were primigravida, 82.33% had > 37 weeks of gestation. In the study group 78.43% were moderately obese, 15.69% were severely obese and only 5.88% were morbidly obese. Most common pre pregnancy medical disorder in obese women were preeclampsia (21.57 %), previous LSCS (20.59 %), severe anaemia (19.54 %), gestational diabetes mellitus (12.75 %), gestational hypertension (9.80 %) & multiple pregnancy (1.96 %). Common intrapartum events were Preterm labor (16.67 %), PPH (6.78 %), Abruptio placenta (4.90 %), Mal presentation Breech (4.90%) & Eclampsia(1.96%).63.71%of obese pregnant women delivered by normal vaginal delivery, 31.37% of obese pregnant women underwent cesaerian section & 4.90% of obese women were requiring instrumental delivery. Common indication for NICU admission were infant of diabetic mother (22.55 %), preterm (14.71 %), meconium aspiration (5.88 %), macrosomia (3.92 %), asphyxia (1.96 %) & transient tachypnia of new born (1.96%). No maternal or neonatal mortality observed in present study.
Conclusion: In obese pregnant women with BMI >30kg/m², higher incidence of gestational hypertension, preeclampsia, gestational diabetes mellitus, anaemia, malpresentation, cephalopelvic disproportions and hypothyroidism isnoted,

The traditional definition of GDM which is still used by ACOG1 is any degree of glucose intolerance that either commences or is first diagnosed in pregnancy. Diabetes is the most common medical complication of pregnancy, women can be separated into those who were known to have diabetes before pregnancy-Pregestational or overt & those diagnosed during pregnancy-Gestational Diabetes. All Antenatal women attending op who are normoglycemic in second trimester are followed in third trimester at 32-34 weeks and repeat Glucose Tolerance Test is done and looked for any abnormal values so that new cases of gestational diabetes mellitus cases are found. Among the study population,15% of population had EFW >90th centile at 32-34 weeks gestation, In GDM mothers 40.9% had EFW >90th centile.

Introduction: Hypertensive disorders complicate 5-10 percent of all pregnancies and contributes greatly to maternal and fetal morbidity and mortality. Women with gestational diabetes are at increased risk of preeclampsia and worsens the fetal prognosis. Thyroid hormones seem to be important in placentation and regulation of early pregnancy, partly explaining the association between hypothyroidism and preeclampsia. Incidence of both hypothyroidism and gestational diabetes was found significantly higher in women with Preeclampsia Induced Hypertension. There are few studies worldwide to establish the association between Preeclampsia, gestational diabetes mellitus and hypothyroidism in pregnancy. Objective: The objective of this study was to determine the association of dual endocrinopathy in pregnancy with severity of preeclampsia. Study Design: Prospective Observational Cross-sectional Study Material and Methods: 400 patients who met inclusion criteria and consented for the study were recruited in the study from November 2015 to October 2016 in the Department of Obstetrics and Gynaecology , SMGS Hospital, Govt Med College Jammu. All patients underwent relevant blood and urine tests. They were grouped into 2 groups – mild and severe preeclampsia. The association of two groups with dual endocrinopathy (hypothyroidism and gestational diabetes mellitus) was studied. Statistical analysis: Chi-square test was employed to determine association of dual endocrinopathy with severity of preeclampsia. P-value less than 0.05 was considered statistically significant. Results: In this study, majority of patients i.e. 70.50% (282 out of 400) were in the mild preeclampsia group and only 29.50% (118 out of 400) were in the severe preeclampsia group. According to present study, 14.4 % of severe preeclampsia patients had dual endocrinopathy while only 7.8 % of mild preeclampsia patients had dual endocrinopathy. This association was calculated using Chi-Square Test and was statistically significant (P value = 0.042).

Introduction Gestational diabetes mellitus (GDM) is one of the most frequent metabolic disorders during pregnancy, with incidence rates ranging from 1.1% to 14.3%. It is important to identify which risk factors may lead to a cesarean delivery, so to plan the procedure in advance and to avoid possible complications for both the mother and the fetus. Therefore this study was conducted to identify the risk factors associated with cesarean section in pregnant women with GDM. Objective : To identify the risk factors associated with cesarean section in pregnant women with GDM Study Design: This was a descriptive observational study conducted in a tertiary care centre over a period of 1 year from January 2018 to December 2018 at SKIMS, Soura, Srinagar, Kashmir Material & Methods: 100 patients of Gestational Diabetes Mellitus were recruited and mode of delivery and various risk factors associated with cesarean delivery were evaluated Results: Among the patients of GDM, who underwent LSCS & NVD, mean age was significantly more (30.8±3.75 years & 28.4±3.42 years respectively, p value -0.010) in LSCS group. BMI was significantly higher in GDM patients who underwent LSCS as compared to patients who underwent NVD (29.7±2.49 kg/m² vs 25.3±1.98 kg/m², p value <0.001). Blood sugar fasting and postprandial values were significantly higher in patients of GDM who underwent LSCS as compared to patients who underwent NVD [ BS(F) - 99±14.11 g/dl vs 87.6±7.51 g/dl, p value <0.001; BS(PP) - 127.7±30.79 g/dl vs 87.6±7.51 g/dl, p value - 0.041]. Prior cesarean section was also an independent risk factor in deciding mode of delivery in patients of GDM. Among the patients who underwent LSCS, maximum were on insulin (56%) followed by diet (33.3%). Among group B (NVD), maximum patients were on diet (56%) followed by metformin (24%) Conclusion: The mean age of patients and BMI was higher in patients who underwent cesarean section (p - 0.010 and < 0.001 respectively). High blood sugar levels (fasting and postprandial), primigravida and prior cesarean section were associated with high chances of cesarean section (p < 0.001, 0.041, 0.007 and 0.001 respectively). There were no significant difference between the 2 groups in regards to gestational age at delivery, the weight of newborn and the apgar score at 1 and 5 minutes after birth.

Objective: Selection of an effective method of delivery for mother and child in pregnant women with gestational diabetes. The retrospective group included 67 women who passed through the regional perinatal center, city maternity complex and family clinics No. 5, No. 6 of the city of Bukhara in the periods from 2016 to 2018. The main (prospect) group consisted of 68 women whose pregnancy proceeded against the background of overt or gestational diabetes mellitus (GDM). The control group consisted of 36 women whose pregnancy proceeded physiologically. As a result of the study, the course of pregnancy and childbirth according to the history of childbirth and own observations revealed that in all (60%) pregnant women with GDM, pregnancy and childbirth proceeded with any complications, like in the mother and the fetus. Thus, pregnancy proceeded against the background of corrected diabetes with the use of the optimal insulin regimen and rational diet therapy, the absence of signs of diabetic fetopathy, then in this category of pregnant women, the delivery through the birth canal is considered the best option.

Background: Obstetric factors may be responsible for some of the differences in neurologic outcomes seen in the offspring of women with maternal thyroid hypofunction compared with their euthyroid counterparts.
Materials & Methods: 80pregnant women with hypothyroidism were subjected to assessment of thyroid profile that includes T3, T4, TSH, and anti-TPO antibody was performed. Pregnancy outcome was recorded.
Results: There were 25 cases of subclinical hypothyroidism in first trimester and 20 in second trimester. 8 cases of Hypothyroxinemia in first and 7 in second trimester. Overt hypothyroid was seen in 10 in first and 6 in second trimester. There were 5 cases in first and 4 cases in second of euthyroid. The mean parity was 1.2, 1.7, 1.1 and 1.0 in subclinical hypothyroidism, hypothyroxinemia, overt hypothyroid and euthyroid respectively. The mean BMI (Kg/m²) was 24.3, 27.8, 26.8 and 24.1. There were current smokersie. 4, 3, 1 and 5 and prior pregnancy was seen in 5, 4, 2 and 1 in subclinical hypothyroidism, hypothyroxinemia, overt hypothyroid and euthyroid respectively. Maximum cases of miscarriage (2) were seen in subclinical hypothyroidism and gestational hypertension (5) in overt hypothyroidism. Pre- eclampsia (1) was seen in subclinical and overt hypothyroid, pre- term PROM (3) hypothyroxinemia, pre- term labor (2) in subclinical hypothyroidism and 5 cases of gestational diabetes mellitus was seen in hypothyroxinemia.
Conclusion: Overt hypothyroidism in pregnancy is detrimental to the developing fetal brain. Pregnancy outcome showed cases of miscarriage, pre- eclampsia, pre- term PROM, pre- term labor and GDM.