European Journal of Molecular & Clinical Medicine

Abstract

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.