Masood Shabeen Naz, Lakho Nusrat, Saeed Saira, Masood Yasir
Dr. Shabeen Naz Masood, MBBS, MCPS, FCPS, PhD, DCPS. Department of Obstetrics & Gynaecology, Isra University, Karachi, Pakistan.
Dr. Nusrat Lakho, MBBS, FCPS. Department of Obstetrics & Gynaecology, Isra University, Karachi, Pakistan.
Pak J Med Sci. 2021 Jul-Aug;37(4):1008-1013. doi: 10.12669/pjms.37.4.3979.
To compare the reliability of non-fasting oral glucose tolerance test (OGTT) versus fasting OGTT for screening of hyperglycaemia in pregnancy (HIP).
This cross sectional analytic study was conducted by the Department of Obstetrics & Gynaecology, Isra University Karachi Campus from October 2016 to April 2017. A total of 225 pregnant women irrespective of gestational age were included in the study. They underwent non fasting 75 grams OGTT. Venous plasma glucose was done 02 hours after the glucose load. Same women were advised to come again within three to seven days for fasting OGTT. Venous plasma glucose (VPG) was estimated in fasting and 2 hours post glucose load.
Using the non-fasting OGTT, out of 204 women, 32 were diagnosed with hyperglycemia. All these 204 women were again called for fasting OGTT three to seven days after the initial non-fasting OGTT. Only nine were diagnosed with hyperglycemia, out of these nine women, seven women who were screen positive on non-fasting OGTT were found to be screen positive on fasting OGTT as well. However, only two women were additionally diagnosed with hyperglycemia who were initially screen negative on non-fasting OGTT. The non-fasting OGTT has diagnosed HIP with sensitivity of 77.7%, specificity of 87.1%, positive predictive value of 21.8% and negative predictive value of 98.8%.
The use of the non-fasting OGTT at first antenatal visit may be a practical approach to detect the HIP as screening and diagnostic tool in the resource constrained settings.
比较非空腹口服葡萄糖耐量试验（OGTT）与空腹OGTT用于筛查妊娠期高血糖（HIP）的可靠性。
本横断面分析研究由卡拉奇伊斯拉尔大学妇产科于2016年10月至2017年4月进行。共纳入225名孕妇，不限孕周。她们接受了非空腹75克OGTT。葡萄糖负荷后2小时测定静脉血浆葡萄糖。建议同一批女性在三至七天内再来进行空腹OGTT。在空腹及葡萄糖负荷后2小时测定静脉血浆葡萄糖（VPG）。
使用非空腹OGTT，在204名女性中，32名被诊断为高血糖。所有这204名女性在首次非空腹OGTT后三至七天再次被要求进行空腹OGTT。只有9名被诊断为高血糖，在这9名女性中，7名在非空腹OGTT筛查呈阳性的女性在空腹OGTT筛查中也呈阳性。然而，只有2名最初在非空腹OGTT筛查呈阴性的女性被额外诊断为高血糖。非空腹OGTT诊断HIP的敏感性为77.7%，特异性为87.1%，阳性预测值为21.8%，阴性预测值为98.8%。
在首次产前检查时使用非空腹OGTT可能是在资源有限环境中作为筛查和诊断工具检测HIP的一种实用方法。
