Research Article
Is it HAPO/IADPSG and NICE/ National Consensus Document criteria for diagnosis of GDM best suit for Sri Lanka; Outcomebased comparative study
Authors:
M. A. Madura M. Jayawardane ,
University of Sri Jayewardenepura, Gangodawila, Nugegoda, LK
About M. A. Madura M.
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences
Maduka Rajakaruna,
University of Sri Jayewardenepura, Gangodawila, Nugegoda, LK
About Maduka
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences
K. A. Supun A. Perera,
University of Sri Jayewardenepura, Gangodawila, Nugegoda, LK
About K. A. Supun A.
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences
U. D. Chandradeva,
University of Sri Jayewardenepura, Gangodawila, Nugegoda, LK
About U. D.
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences
H L. Thilakshi C. Abeywickrama,
University of Sri Jayewardenepura, Gangodawila, Nugegoda, LK
About H L. Thilakshi C.
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences
Ajith Fernando
University of Sri Jayewardenepura, Gangodawila, Nugegoda, LK
About Ajith
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences
Abstract
Objective: Our aim in this study is to compare pregnancy and fetal outcomes following the diagnosis of gestational diabetes according to HAPO/IADPSG, NICE criteria or when using both criteria.
Methods: Diagnosis of GDM was made using the lowest recommended cut off values of HAPO/IADPSG criteria and NICE criteria. NICE diabetes in pregnancy guidelines were used in management once GDM was diagnosed. The outcomes of the three groups were compared, Group A: the patients diagnosed using any criteria, Group B: only from HAPO/IADPSG criteria (patients fasting value within 92-100 mg/dL and other values with in the normal). Group C: only from NICE criteria (patients with 2nd hour value within 140-153 mg/dL but the rest were normal)
Results: Out of all women with GDM 70% were in group A, 25% in group B, and only 4% in group C. 62% of women needed metformin or insulin apart from Medical nutrition therapy in Group A, and 50% in group B and only 17% in group C. Average period of gestation at the delivery in Group A was 37 weeks and 3 days , and it is 37+5 for group B and 38+4 for group C. Induction rate in Group A was 56%, 14% in Group B and 4% in Group C.LSCS rate was 48% in Group A, 41% in group B and 36% in group C. 7% of babies were macrosomic in Group A, 2% and 1% respectively in groups B and C. Special Care Baby Unit (SCBU) admission rates were 11% in group A and 1% in group B. The average birth weights of Group A were 2.93kg, Group B 2.900kg and group C 2.818kg.
Conclusion: HAPO/IADPSG criteria diagnosed more women with gestational diabetes than NICE criteria. Only 4% of mothers will be missed if HAPO/IADPSG criteria is used. Pregnancy outcomes of the Group B is similar to that of Group A and 50% of women needing further intervention apart from MNT could have prevented adverse pregnancy outcome in a significant number of patients compared to the few number of patients in group C. It was observed that IADPSG criteria provide better diagnostic cut-off values for our population compared to NICE. Limited number of patients especially in group C is a limitation of this study to evaluate further since this is an on-going observational study and will be able to provide more information in the future.
How to Cite:
Jayawardane, M.A.M.M., Rajakaruna, M., Perera, K.A.S.A., Chandradeva, U.D., Abeywickrama, H.L.T.C. and Fernando, A., 2022. Is it HAPO/IADPSG and NICE/ National Consensus Document criteria for diagnosis of GDM best suit for Sri Lanka; Outcomebased comparative study. Sri Lanka Journal of Obstetrics and Gynaecology, 44(3), pp.146–152. DOI: http://doi.org/10.4038/sljog.v44i3.8036
Published on
21 Dec 2022.
Peer Reviewed
Downloads
