Screening for gestational diabetes

Objective: To indentify a widely available and acceptable screening procedure for the diagnosis of gestational diabetes mellitus to improve the obstetric prognosis of mother and baby in a developing country having high morbidity and mortality. Methods: Prospective study of all pregnant women registering at antenatal clinic of Shaikh Zayed Hospital and National Health Research Complex, Lahore, Pakistan, utilizing modified O'Sullivan's criteria. Two thousand and sixty consecutive women registering during a 24 month period at Shaikh Zayed Hospital. Implementation of program to test all pregnant women for gestational diabetes mellitus at 24-28 weeks of gestation. Results: The glucose challenge test was abnormal (2 hr plasma glucose a 7.77 mmol/l) in 5.24% of the screened population. Those women, who had an abnormal glucose tolerance test were subjected to oral glucose tolerance test at 28-32 weeks of gestation. This revealed a prevalence of 3.59% with abnormal glucose tolerance. Among them 2.08% had gestational diabetes mellitus and 1.50% had impaired glucose tolerance test based on the modified O'Sullivan's criteria. Conclusion: In a developing country, because of high perinatal complications, all pregnant women should undergo glucose tolerance test using the modified O'Sullivan's criteria.