Background: Gestational diabetes is type 1 or 2. Preconception treatment reduces problems, while poor blood glucose management increases congenital deformity risk. Diet, insulin, or oral medications are essential for blood sugar control, including insulin transition during pregnancy. Substandard care of diabetic women contributes to maternal and fetal morbidity and mortality.
Objectives: Evaluate diabetes care in pregnancy at Qena University Hospital, as compared to NICE recommendations.
Patients and methods: This Study conducted at South Valley University, covering pregnant diabetics from Jan 2019 to Dec 2020. Diabetes management during pregnancy was assessed in preconception, maternal, intrapartum, and postnatal stages. Patient assessment included history, physicals, and blood tests. Ultrasound determined fetal health, gestational age. Outcomes encompassed maternal glycemia, complications, preterm birth, cesarean section, neonatal issues.
Results: 83.3% received pertinent information, 72.2% embarked on planned pregnancies, 5.6% underwent retinal assessment, 100% received renal assessments, and 94.4% underwent HbA1c monitoring. 17.5% had glucose monitoring, 86.0% conducted ketone testing, 22.8% underwent retinal assessments, 100% received renal assessments, 80.37% underwent anomaly scans, 54.4% monitored fetal well-being, 17.5% took measures to prevent pre-eclampsia, 19.3% received antenatal care facilitated by MDT. 52.6% had DKA attacks and 26.3% had hypoglycemic attacks. 40.4% delivered before 34 weeks of gestation, 47.4% delivered between 34-37 weeks. 77.2% required admission to the NICU. Macrosomia was in 3.51% and polyhydramnios was in 1.75%. 59.6% had cesarean section.
Conclusion: Defective preconceptional and antenatal care were evident in a great proportion of patient this raise alarm for enhancing the standard of obstetric and medical management of pregnancy.