Djagadou Kodjo Agbeko, Tchamdja Toyi, Némi Komi Dzidzonu, Balaka Abago, Djibril Mohaman Awalou
Service de Médecine Interne, Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo.
Service de Médecine Interne, Faculté des Sciences de la Santé, Université de Kara, Kara, Togo.
Pan Afr Med J. 2019 Sep 10;34:18. doi: 10.11604/pamj.2019.34.18.18917. eCollection 2019.
The purpose of this study was to describe the diagnostic, prognostic and therapeutic features of gestational diabetes at the Sylvanus Olympio University Hospital Center.
We conducted a retrospective descriptive study over a period of 5 years from 1 January 2013 to 31 December 2017. It involved 125 pregnant women who had given birth in the Department of Internal Medicine and in the Gyneco-Obstetric Department.
The average age of patients was 30.84±4.17 years. The most common risk factors were overweight and obesity (57.7%), a family history of diabetes (33.3%), a history of spontaneous miscarriage (26.6%), a history of fetal death in utero (15.5%) and a history of gestational diabetes (8.8%). Gestational diabetes screening was performed using fasting blood glucose test and 75g oral glucose-tolerance test. Diagnosis was made in the first quarter in 55.6% of cases, in the second quarter in 33.3% and in the third quarter in 11.1%. Insulin therapy was necessary in 24.4% of cases and a healthy meal-plan alone in 66.6%. Sixty-six point seven percent (66.7%) of women had given birth by cesarean section and 33.3% vaginally. Maternal complications at birth included: arterial hypertension (22.2%), preeclampsia (17.7%) and premature ruptured membranes (2.2%). Newborn complications included macrosomia (48.9%), prematurity (11.1%), hypoglycaemia (11.1%), malformations (4.4%) and stillborn child (4.4%). Eighty-eight point nine percent (88.9%) of newborns had Apgar score greater than 7 and more than 48% were macrosomes.
Gestational diabetes leads to maternofetal complications. Systematic screening is essential even in the absence of risk factors for optimal patient management.
本研究的目的是描述西尔瓦努斯·奥林匹奥大学医院中心妊娠糖尿病的诊断、预后和治疗特征。
我们进行了一项回顾性描述性研究,研究时间为2013年1月1日至2017年12月31日这5年期间。研究对象为在内科和妇产科分娩的125名孕妇。
患者的平均年龄为30.84±4.17岁。最常见的风险因素是超重和肥胖(57.7%)、糖尿病家族史(33.3%)、自然流产史(26.6%)、子宫内胎儿死亡史(15.5%)和妊娠糖尿病史(8.8%)。采用空腹血糖检测和75克口服葡萄糖耐量试验进行妊娠糖尿病筛查。55.6%的病例在第一季度确诊,33.3%在第二季度确诊,11.1%在第三季度确诊。24.4%的病例需要胰岛素治疗,66.6%仅需健康饮食计划。66.7%的女性通过剖宫产分娩,33.3%通过阴道分娩。分娩时的母体并发症包括:动脉高血压(22.2%)、先兆子痫(17.7%)和胎膜早破(2.2%)。新生儿并发症包括巨大儿(48.9%)、早产(11.1%)、低血糖(11.1%)、畸形(4.4%)和死产儿(4.4%)。88.9%的新生儿阿氏评分大于7分,超过48%为巨大儿。
妊娠糖尿病会导致母婴并发症。即使没有风险因素,系统筛查对于优化患者管理也至关重要。