RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA
ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. / NAME OF THE CANDIDATE AND ADRESS (IN BLOCK LETTERS) / DR. KAVYASHREE K.S,
D/O K.V.SHIVARAMGOWDA,
#7, OLD POST OFFICE ROAD,
7TH BLOCK, JAYANAGAR,
BANGALORE – 560082.
2. / NAME OF THE INSTITUTION / J.S.S MEDICAL COLLEGE.
3. / COURSE OF STUDY AND SUBJECT / M.S.(OBG)
4. / DATE OF ADMISSION TO COURSE / 31-5-2007
5. / TITLE OF THE TOPIC / MATERNAL COMPLICATIONS AND PERINATAL OUTCOME IN DIABETES COMPLICATING PREGNANCY.
6. / BRIEF RESUME OF THE INTENDED WORK:
6.1 / Need for study:
Diabetes is the most common medical complication of pregnancy with increasing prevalence of late1. It could be pregestational (overt) or gestational diabetes mellitus. Pregnancy complicated by diabetes is associated with both maternal and fetal adverse outcome like increased incidence of pregnancy induced hypertension in the mother and macrosomia, hypoglycemia and hyperbilirubinemia in the baby2.
Hence the present study is carried out to study the maternal complications and perinatal outcome in pregnancy complicated by diabetes.
6.2
6.3 / Review of literature:
Indian women have an eleven fold increased risk of developing glucose intolerance during pregnancy compared to Caucasian women. They have the highest frequency of GDM , recent data showing 16.55% prevalence of GDM 1. Maternal complications such as pregnancy induced hypertension and placental abruption are significantly associated with GDM2.Babies born to women with GDM are eight times more likely to have hypoglycemia and three times more likely to develop jaundice requiring phototherapy2. Jacobson et al found that the rate of caesarean section was higher in patients with GDM and this is also associated with increased infectious complications3. Cundy et al found perinatal mortality of 46.1/1000 in type II diabetes mellitus, significantly higher as compared to general population (12.5) and GDM (8.9) owing to seven fold increase in the rate of late fetal death4. Hence screening for glucose intolerance during pregnancy is mandatory. As more than 40% of cases are missed with selective screening , universal screening should be favored5.
Targeting delivery early in term, better glycemic control during pregnancy, improved neonatal care and early screening for fetal abnormalities are likely to contribute to improved maternal and perinatal outcome6. An intensified management approach is significantly associated with enhanced perinatal outcome .This strategy clarifies the relation between glycemic control and neonatal outcome7.
Objectives of the study
·  To study maternal complications in diabetes complicating pregnancy.
·  To study the perinatal outcome of babies born to diabetic mothers.
7.0 / MATERIALS AND METHODS:-
7.1 Source of data
The study will be conducted on minimum of 50 antenatal patients diagnosed as overt diabetes and GDM admitted in J.S.S.Hospital during the study period that is from Nov 2007 to Sep 2009.
7.2 Method of collection of Data
A prospective study of inpatients who are diagnosed as diabetes mellitus both overt and gestational.
·  Data will be collected in a predesigned proforma.
·  History taking, clinical examination, biochemical tests to measure blood glucose levels will be done.
·  Appropriate statistical methods will be used.
Inclusion criteria
Pregnant women diagnosed as diabetic, both overt and gestational.
Exclusion criteria
Pregnant women with diabetes, having other medical complications like essential hypertension, heart disease, epilepsy and renal disorders.
7.3 Does the study require any investigations or interventions to be conducted on patients or other human or animals? If so, please describe briefly.
Yes
·  OGCT and OGTT
·  Obstetric scan
·  Fundoscopy
·  Level Hb A1C in maternal serum
·  Biochemical tests in the newborn baby like blood glucose, serum calcium levels and serum bilirubin.
7.4 Has ethical clearance been obtained from your institution in case 7.3.
Yes
8 / List of references
1. V Sheshaiah, V Balaji, Madhuri S Balaji, Aruna Sekar, One step procedure for screening of gestational diabetes mellitus. J Obstet Gynecol India. 2005 Nov / Dec;Vol 55:No 6.
2. Gajjar F, Maitra NK, Intrpartum and perinatal outcomes in women with gestational diabetes and mild gestational hyperglycemia. J obstet Gynecol India. 2005 Mar /Apr ; Vol 55:No 2.
3. Jacobson JD, Cousinsl. A population based study of maternal and perinatal outcome in patients with gestational diabetes. Am J Obstet Gynecol.1989 Oct;161(4):981-6.
4. Cundy T, Gamble G, Townend K, Henley PG, Macphersons, Robert AB.
Perinatal morality in type 2 diabetes mellitus. Diabet Med. 2000 Jan;17(1):33-9
5. Lucas MJ. Diabetes complicating pregnancy. Obstet Gynecol clin North Am.2001 Sep; 28(3):513-36.
6. Jonathan W, Carol A, Mark A. Gestational diabetes: does the presence of risk factors influence perinatal outcome?. Am J Obstet Gynecol.1994 Oct; 171(4)1003-1007.
7. Langer, Oded ,Rodriguez, Deborah A, Xenakis , Elly MJ. Intensified versus conventional management of gestational diabetes. Am J obstet Gynecol.1994 April;170(4):1036-1047.
9. / Signature of the candidate
10. / Remarks of the Guide / Diabetes complicating pregnancy puts both the mother and the fetus at risk and it is associated with increased maternal and perinatal morbidity and mortality. Early detection and proper management will improve the maternal and perinatal outcome.
Hence the present study is conducted.
11. / 11.1 Guide
11.2 Signature / DR. SUMA.K.B,
ASSOCIATE PROFESSOR,
DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY,
J.S.S. MEDICAL COLLEGE.
11.3 Co – Guide
11.4 Signature
11.5 Head of the department
11.6 Signature / DR.PRASHANTH.S.N,
ASSOCIATE PROFESSOR,
DEPARTMENT OF PAEDIATRICS,
J.S.S.MEDICAL COLLEGE.
DR. AMBARISHA BHANDIWAD,
PROFESSOR AND HOD,
DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY,
J.S.S. MEDICAL COLLEGE.
12. / 12.1 Remarks of the chairman
and principal.
12.2 Signature