Abstract
To observe the effects of exogenous insulin on placental, fetal and maternal outcomes in Gestational Diabetes Mellitus (GDM). After screening and diagnoses(WHO criteria) 30 GDM patients(Group A) were kept on diet control and 39 GDM (Group B) who did not achieve glycemic targets were added subcutaneous insulin. Term placental weight, size, shape, consistency, fibrinoid necrosis, hemorrhages, cord color, length of the cord, completeness of membranes, weight and condition of baby and mode of delivery were assessed in 25 patients in each group. Placental weight, cord width and baby weight were found to be more in Group B, than Group A and were statistically significant with p value 0.005, 0.02 and 0.003 respectively. Ten patients in group A and 17 patients in group B had cesarean deliveries. Exogenous insulin produces significant effects on the placental, fetal and maternal outcomes in patients with GDM.
Highlights
Morphological study of placenta which occupies central position between the mother and fetus might be helpful in elucidating these adverse fetal and maternal outcomes in gestational diabetes. With this background present study was designed to observe the effect of exogenous insulin on the gross morphology of placenta, fetal and maternal outcomes in gestational diabetics in our setting
The study was approved by Ethical Review Board (ERB) and Institutional Review Board (IRB) of Dow University of Heath Sciences
Placental weight and cord width were more in Group B with significant p value of p=0.005 and p=0.02 respectively
Summary
“Gestational Diabetes is defined as any degree of glucose intolerance with onset or first recognition during the pregnancy”. Subcutaneous insulin is the traditional therapy and gold standard under such circumstances.[9] Even with this pharmacotherapy, fetal and maternal morbidity and mortality are well documented in the literature.[10] Morphological study of placenta which occupies central position between the mother and fetus might be helpful in elucidating these adverse fetal and maternal outcomes in gestational diabetes. With this background present study was designed to observe the effect of exogenous insulin on the gross morphology of placenta, fetal and maternal outcomes in gestational diabetics in our setting
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