Naheed Farrukh, Kammeruddin Karim, Hashmi Haleema A, Narijo Sabhagi
Department of Obstetrics and Gynaecology, Baqai Medical University, Karachi.
J Coll Physicians Surg Pak. 2008 Feb;18(2):82-5.
To determine the frequency of impaired oral glucose tolerance test in high risk pregnancies for Gestational Diabetes Mellitus (GDM).
Cross-sectional study.
The study was conducted in Obstetric Ward and outpatient department, at Baqai Hospital, Nazimabad and Fatima Hospital, Baqai Medical University, Karachi, from May to October 2005.
A total of 50 high risk pregnancies for gestational diabetes mellitus were selected through outpatient department of obstetrics. Data was collected according to certain obstetric and non-obstetric risk factors for GDM as inclusion criteria through a designed proforma i.e. family history of diabetes, macrosomia (i.e, wt > 3.5 kg), abortions, grand multiparity, a sudden increase in weight (>1 kg/wk) during pregnancy, age > 35 years, early neonatal deaths/sudden IUDS, polyhydramnios, urogenital infections (vulvo-vaginal candidiasis and UTI), previous history of GDM, congenital abnormalities (with or without polyhydramnios) and multiple pregnancy. Oral glucose tolerance test was performed and analyzed according to American Diabetic Association criteria, 2004.
The most frequent risk factors were family history of diabetes mellitus in 1st degree relative and large-for-dates babies in 18 patients. Similarly, high risk factors such as history of abortions and grand multiparity were present in 16 and 14 pregnant women respectively. Least common factors, which contributed for GDM, were polyhydramnios in 4 cases and perinatal mortality (due to congenital anomalies of foetus, intrauterine deaths or neonatal deaths) seen only in 5 cases. Overall impaired oral glucose tolerance test was found in 24%. Most patients had one (17%) or two risk factors commonly (23%). Only 2% had shown five or more risk factors.
Oral glucose tolerance test is a useful diagnostic tool to detect GDM in high risk pregnancies, depending upon the high frequency of number of risk factors in each individual.
确定妊娠期糖尿病（GDM）高危妊娠中口服葡萄糖耐量试验受损的频率。
横断面研究。
2005年5月至10月在卡拉奇纳齐马巴德的巴凯医院产科病房和门诊部以及巴凯医科大学法蒂玛医院进行该研究。
通过产科门诊共选取50例妊娠期糖尿病高危妊娠。根据某些作为纳入标准的产科和非产科GDM危险因素，通过设计好的表格收集数据，即糖尿病家族史、巨大儿（即体重>3.5千克）、流产、多产、孕期体重突然增加（>1千克/周）、年龄>35岁、早期新生儿死亡/突然宫内死亡、羊水过多、泌尿生殖系统感染（外阴阴道念珠菌病和尿路感染）、既往GDM史、先天性异常（有或无羊水过多）和多胎妊娠。根据2004年美国糖尿病协会标准进行口服葡萄糖耐量试验并分析。
最常见的危险因素是一级亲属中有糖尿病家族史，18例患者中有巨大儿。同样，分别有16例和14例孕妇存在流产史和多产等高危因素。导致GDM的最不常见因素是4例羊水过多和仅5例围产期死亡率（由于胎儿先天性异常、宫内死亡或新生儿死亡）。总体口服葡萄糖耐量试验受损的比例为24%。大多数患者通常有一个（17%）或两个危险因素（23%）。只有2%的患者有五个或更多危险因素。
口服葡萄糖耐量试验是检测高危妊娠中GDM的有用诊断工具，这取决于每个个体危险因素数量的高频率。
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