Clinical Management and Maternal Outcomes Among Women with Gestational Diabetes Mellitus

Abstract

Background: Effective clinical management, whether through dietary modification alone or supplemented with insulin therapy, is central to minimising maternal morbidity in gestational diabetes mellitus (GDM), yet the descriptive relationship between management approach and maternal outcome remains under-reported in South Asian tertiary-care populations. This study aimed to describe the clinical management approach adopted for GDM and its associated maternal outcomes at a tertiary-level hospital. Methods: This cross-sectional observational study included 100 women with confirmed GDM managed at a tertiary hospital in Dhaka between March and August 2017. Data on antenatal management, postpartum insulin requirement, antenatal complications, mode of delivery and postnatal complications were extracted from antenatal and hospital records and analysed using SPSS version 20, with the chi-square test applied at a significance level of p<0.05. Results: Dietary modification alone was sufficient for 56% of patients, while 44% additionally required insulin during pregnancy; postpartum, this requirement fell sharply, with 90% of patients managed on diet alone and only 10% continuing to require insulin. Antenatal complications occurred in 56% of patients, most frequently urinary tract infection (18%), polyhydramnios (12%) and pre-eclampsia (10%). Caesarean section was performed in 76% of deliveries. Postnatal maternal complications, principally postpartum haemorrhage, wound infection and urinary tract infection, occurred in 28% of patients, with no maternal mortality recorded. Conclusion: The majority of GDM patients in this cohort were successfully managed through dietary modification, with a marked reduction in insulin requirement following delivery and no maternal mortality despite a substantial antenatal complication and caesarean delivery burden, supporting the value of structured, vigilant, multidisciplinary management of GDM.