Gestacional diabetes and perinatal morbimortality in Medellín, Colombia

Abstract

Retrospective analysis of 166 pregnant women with gestational diabetes mellitus, at San Vicente de Paúl Hospital, Medellín, Colombia, evidenced inadequate registration of information and lack of clinical management protocols, despite the fact that this is a reference institution. Gestational diabetes mellitus (GDM) was found in 81 patients (48.8%), non-insulin-dependent diabetes mellitus (NIDDM) in 69 (41.5%) and insulin-dependent diabetes mellitus (IDDM) in 16 (9.6%). Perinatal morbidity rate was 52.2% (72 cases among the 138 in which information was available), distributed as follows: macrosomy (16 cases; 22.2%), acute fetal distress (15 cases; 20.8%), chronic fetal distress (10 cases; 13.9%), polyhydramnios (9 cases; 12.5%), hypoglycemia (8 cases; 11.1 %) and delivery fetal trauma (6 cases; 8.3%). It was remarkable that the potentially preventable entities (macrosomy, acute and chronic fetal distress, polyhydramnios, fetal trauma and respiratory failure syndrome) were more frequent in NIDDM and GDM groups, indicating an inadequate clinical management; fetal mortality was 3.6% (5 patients) mostly associated to maternal hypertension. These results point out to the urgent need of establishing in this third level hospital an interdisciplinary management protocol of gestational diabetes, with apropriate registration of information and clear clinical guides