EFFECT OF HBA1C LEVEL ON MODE OF DELIVERY
DOI:
https://doi.org/10.52206/jsmc.2016.6.2.781-784Abstract
BACKGROUND: Perinatal outcome is related to the onset and duration of glucose intolerance. The
objective of the study is to determine the effect of HbAlc on mode of delivery in Obs/Gynea department
of Saidu Teaching Hospital, Swat.
MATERIAL AND METHODS: This observational & descriptive study was carried out in the
Department of Obstetrics and Gynecology at Saidu Teaching Hospital, Swat, from 1st March 2015 to
29th Feb 2016. Total 313 pregnant women were included in the study, who had Gestational Diabetes or
Established Diabetes.Detail history was taken regarding maternal age in years, gestational age in weeks.
Abdominal examination was done for lie and presenting part of the fetus, and vaginal examination were
performed. These patients were followed till the end of labour and their mode of delivery i-e; normal
vaginal delivery, instrumental delivery or cesarean section was recorded. Maternal HbAlc level was
done at the time of delivery and was categorized as Mild (< 6.5), Moderate (6.5-9) and severe (>9).
Maternal HbAlc was measured in hospital laboratory. The numerical variables of mean HbAlc,
maternal age in years and gestational age in weeks were analyzed by mean ± SD (range). Categorical
variables like; grades of severity of HbAlc levels and frequency of modes of delivery were analyzed by
frequency (number) and relative frequency (percentages). SPSS 20 (SPSS Inc. Chicago, Illnios, USA)
was used to analyze the data.
RESULTS:The total number of patients was 313. Mean age of the study population was 27.85 ± 6.37
(43 - 15) (95% Cl 28.39 - 27.30). The mean age of gestational amenorrhea, at which most of the
patients presented was 38.31 ± 3.02, ranging from 41 to 29, (95%CI 38.57 - 38.5). The mean
glycosylated Hemoglobin (HbAlc) was 6.9 ± 1.69 (95% Cl 6.17 - 5.88). Majority of the patients had
poorly controlled diabetes, i-e: 64%. In different levels of HbAlc levels, normal vaginal delivery was
the pre dominant mode of delivery.
CONCLUSION:^ patients with uncontrolled diabetes the rate of complications increased and so does
the rate of macrosomia and fetal distress, leading to higher rate of cesarean section and instrumental
delivery, so by strict control of the blood sugar levels in a diabetic patient one can reduce the risk of
operative deliveries and complications.
KEY WORDS:Hbalc levels, Mode of delivery, cesarean section
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