Gestational Diabetes Sreening in Wangsapung Hospital

Abstract

Introduction: Gestational diabetes mellitus (GDM) screening is useful in caring mother and baby. Carpenter&Coustancriteria is useful in predicting type 2 Diabetes mellitus of the mother (2 step screening), but International association of diabetes and pregnancy study groups (IADPSG) criteria attempt to redefine GDM in terms of adverse pregnancy outcomes (macrosomia, LGA infant, shoulder dystocia) by universal screening 75 g OGTT that can detect GDM in 3 times higher than Carpenter and Coustan criteria.

Method: Wangsapung Hospital screened GDM along American Diabetes Association 2010 criteria (2 step screening, take a 50 g glucose challenge test (GCT) in moderate risk group (cut-off point is >130 mg/dl), take 75 g OGTT in high risk group and positive glucose challenge test group). Risk factor was modified to fit in condition in 2010 (cut-off BMI value in obesity for Asian is 27). Data was recorded in HosXp& Microsoft Access Program in antenatal care clinic 2011-2017 that include 6622 pregnancies, then observe the incidence of GDM, rate of the risk factor, and estimated the cost.

Result: This study include 6,622 pregnancies. The mean age of population was 28.5 year (SD 5.94). The everage of initial gastational age was 23.18 weeks (SD 6.8). The pregnancy were tested GCT or OGTT 53.49% (3542/6622). The Average GDM incidence was 10.72% (712/6622; 6.62%-16.90%).

Conclusion: The use ADA 2010 recommendation for screening GDM is easy in application to reduce waiting time for the patients (100 g OGTT: 3 hrvs 75 g OGTT: 2 hr), to reduce the expense of the hospital (46.51% reduction compare to IADPSG that test 75 g OGTT in all pregnancy.