A COMPARATIVE STUDY OF MATERNAL EVENTS WITH TIGHT GLYCEMIC CONTROL IN DIABETIC

Diabetic pregnancies are associated with increased obstetric and diabetic maternal complications, which can be lowered by normoglycemia. Two hundred forty diabetic pregnancies were selected and segregated into gestational diabetes mellitus (GDM,176) and pre gestational diabetes mellitus (PGDM,64). Each group was divided into 3 sub groups according to the terminal levels of glycemic indices. Tight control group (TC) had fasting plasma glucose (FPG) 95mg. /dl, PPPG > 120mg/dl and HBA 1C > 7.5%. Intra-group and international data comparisons of complications were done for the parameters of lower segment caesarean section (LSCS), pregnancy induced hypertension (PIH), preterm labor (PTL), wound sepsis (WS), and postpartum hemorrhage (PPH). LSCS had a very high incidence for all sub groups. Tight control increased LSCS and lowered the incidences of PTL and WS in GDM but other parameters were unaltered. In PGDM, LSCS increased significantly with tight control but the rest was unaffected. Total complications excluding LSCS were not significantly different between the UC sub groups of GDM and PGDM. Compared to the international data GDM outcome was worse while PGDM results were similar. In conclusion, tight control was beneficial for preventing some, but not all maternal complications. The role in PGDM was not very clear, probably, preconception status and associated vasculopathy were important confounding factors.