Complications of Gestational or Overt Diabetes on Mothers and Newborn Babies
Résumé
Background: Diabetes in pragnancy is associated with increase risks of Fetal, neonatal, and lifelong complication in the offspring. In infants of diabetic Mother (IDMs) hypoglycemia is a common complication. Aim of Study: To study complication of gestation or overt Diabetes in Mothers and neonatal complication in Benghazi, Libya, at Benghazi Children hospital in last 4 years. Setting and Design: This is descriptive, case series retrospective study was conducted at Benghazi children hospital, Libya. This study include 40 patients was referred From the Nursery department of the Gynaecologiet and osteteric Eljamaharia hospital during peroid from 01.01.2016 to 01.06.2020. Subjective and Methods: ALL patients aged Less than 4 weeks, both males and Females are included and babies from different socio-economic classes were included. Most of the babies were from benghazi city, some patient From surrounding small Villages away from benghazi and some Cases referred from some cities From east and west to beaghazi .All patient born to over diabetic mothers or had gestational diabetes. Methods: At The time of the study, the available a data From the Files was recorded in special Case sheets as follow:- —Complication of overt diabetes or gestational diabetes on The Mother: Available data From the File was include:- Incidence of abortion. Mode of Delivery. —Complication in infant of Diabetic Mothers These include:- Birth weight. Blood Glucose Level. Bilirubin level and its treatment. Birth injurie. Congenital anormalis overt or these detected by Echo and Abdominal ultrasound. Prognosis (Discharge or expired babies). All these data were analyzed by SPSS version 18.0 software, and they will be presented as absolute number, percentage and means. Results: This study was conducted retrospectively during last 4 ½ years, it was included 40 patients, 24 patients were male (60%) and 16 patients were female (40%), male to female ratio 1.5:1 Maternal complication: Incidence of abortion:- Eighteen out of 40 cases had history of Abortion (45%). Mode of delivery: Twenty-eight out of 40 cases were delivered by C.S (70%). Infant complication: Birth weight: Out of 40 cases, 29 babies (72.5%) were macrocosmic and only one case collected as SGA and premature baby (2.5%). - Risk of hypoglycemia: In this study we found 20 cases had Blood glucose level less than 30 mg (50 %), and rest of cases had Blood glucose level more than 30 mg. - Hypocalcemia: In 21 cases, serum calcium were studied, and we found 9 (42.8 %) cases their serum calcium below 7 mg. - Hyperbilirubinemia: In this study,19( 47.5%) cases were found to had S.Bil more than 15 mg % (Regardless of other contributed factor like Bl. Incompatability, prematurity or birth injuries), and for these babies, DVET ( Double volume exchange transfusion ) done for 6 babies (31.5%) and rest were treated by phototherapy. :Birth injuries - Out of 40 cases, birth injuries were detected in 7 cases (17.5%). -Congenital anomalies: Include overt and those detected by Echo and ultrasound screen. i- by Echo: In this study we found 20 cases (50 %), had cardiac lesion detected by Eccho screen. ii– by Abdominal and brain ultrasound : In only one case was detected by abdominal U.S to had renal vein thrombosis of left kidney. And another case had mild dilation of left lateral ventricle of the brain. Conclusion: From our study of complication occurred in gestational or overt diabeticmothers and their infants, we conclude that: Women with overt or gestational diabetes had asignificant risk of spontaneous abortion.Majority of pregnant women with overt or gestational diabetic were delivered by caesarian section. Our babies of gestational or diabetic mothers were at aconsiderable risk of macrosomia and its complicatio, riskof hypoglycemia, hypocalcemia, hyperbilirubinemia and congenital malformation.