Hyperemesis Gravidarum and 75 Gram Oral Glucose Tolerance Test
Condition: Hyperemesis; Gravidarum, With Dehydration; Gestational Diabetes
MeSH terms: Diabetes, Gestational; Hyperemesis Gravidarum; Dehydration
Study type: Observational

Summary: 
      Hyperemesis gravidarum (HEG) is not only nausea and vomiting of pregnancy, but it is also a
      clinical syndrome including endocrine and metabolic complications. Recently, some
      investigators have been begun performing researches related to the development of gestational
      diabetes mellitus (GDM) in pregnant women with HEG because they think about those metabolic
      and endocrine complications of HEG.In the literature there are few studies assessing how HEG
      has effects on GDM or 75 gram oral glucose tolerance test (OGTT). So the investigators aim to
      evaluate the effects of HEG on 75 gram OGTT.
    

Detailed description: 
      This retrospective controlled study conducted by Obstetrics and Gynecology clinics of Kayseri
      Training and Research Hospital.Pregnant women who delivered at the Kayseri Education and
      Training Hospital of Medicine, in Turkey, between January 2010 and September 2016 were
      identified.This study was carried out with two groups. The study group consisted of women
      hospitalized for Hyperemesis gravidarum (HEG) during first trimester of their pregnancy,
      whereas the control group included all other women who delivered in the same period.Screening
      for GDM was performed twice during pregnancy. The first screening was performed during the
      first trimester using the random plasma glucose test with a cutoff value of 109 mg/dl.
      Screening for GDM was performed for all women during their first prenatal visit, regardless
      of the presence or absence of hyperemesis-associated symptoms.The second screening was
      performed during the second trimester, between 24 and 27 weeks, using a 75-g oral glucose
      tolerance test (OGTT), after pregnant women with HEG got rid of hyperemesis. GDM was
      diagnosed on the basis of the universal criteria established by the International Association
      of Diabetes and Pregnancy Study Group: a plasma glucose level that met or exceeded the
      fasting cutoff value 92 mg/dl, the first-hour cutoff value 180 mg/dl, or the second-hour
      cutoff value 153mg/dl.

      To be considered for diagnosis of pre-gestational diabetes mellitus, women had to meet at
      least one of the following criteria: the fasting plasma glucose test with a cutoff value of
      126 mg/dl or the random plasma glucose test with a cutoff value of 200 mg/dl or the
      second-hour cutoff value 153mg/dl after 75 gram OGGT (American Diabetes Association) The
      delivery midwifery and medical records were retrospectively evaluated. All of the patient's
      body mass index (BMI,calculated as weight in kilograms divided by the square of height in
      meters), urine ketone levels and ages were recorded separately both in the initial exam and
      during performing 75 gram OGTT.
    

Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        This study was carried out with two groups. The study group consisted of women hospitalized
        for HEG during first trimester of their pregnancy, whereas the control group included all
        other women who delivered in the same period. When the pregnant women had those symptoms
        such as the presence of intractable vomiting during pregnancy associated with dehydration,
        electrolyte,and/or metabolic disturbances, as well as a weight loss 5% or more, they were
        diagnosed as HEG.
      
Keywords: Hyperemesis gravidarum; gestational diabetes mellitus; oral glucose tolerance test