Screening For First Trimester's Hyperglycemia in High and Low Risk Pregnancy

Study Overview
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Brief Summary
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Glucose intolerance is the commonest medical disorder complicating pregnancy. Hyperglycemia increases the risk of delivering a large for gestational age newborn (LGA) and related complications such as operative delivery, birth trauma and the poor adaptation of the newborn . Maternal risks of GDM include also polyhydramnios, preeclampsia, premature delivery, prolonged labor, uterine atony, postpartum hemorrhage, infection and progression of retinopathy which are the leading global causes of maternal morbidity and mortality .Detection of women at higher risk for GDM early in pregnancy is a desirable goal because interventions such as diet, medication, and exercise may be applied earlier in pregnancy and potentially can reduce later development of GDM or its associated morbidities. Most GDM cases are diagnosed after mid-gestation following an abnormal glucose challenge test (GCT). However, about 10% of patients with GDM can be diagnosed in the first trimester.

Official Title
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Screening For First Trimester's Hyperglycemia in High and Low Risk Pregnancy

Conditions
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Screening for Hyperglycemia in First Trimester in High and Low Risk Pregnancy

Intervention / Treatment
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* Diagnostic Test: blood sugar


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • History of gestational diabetes in previous pregnancies Polycystic ovaries syndrome History of Macrosomic baby in previous pregnancies Past history of late third trimester fetal demise Past history of polyhydramnios Overweight /Obese women Women diagnosed to have other endocrinopathies like suprarenal, thyroid or pituitary disorders Multi fetal pregnancies Past history of shoulder dystocia Past history of preeclampsia Family history of diabetes In addition, a comparable group of low-risk women will be included like primigravida healthy women or those with normal obstetric history. Exclusion Criteria: all patient not have thev inclusion criteria
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| high risk pregnancy<br>Pregnant women with history of gestational diabetes in previous pregnancies, Polycystic ovaries syndrome, history of Macrosomic baby in previous pregnancies, Past history of late third trimester fetal demise, Past history of polyhydramnios, Overweight /Obese women, Women diagnosed to have other endocrinopathies like suprarenal, thyroid or pituitary disorders, multi fetal pregnancies, Past history of shoulder dystocia, Past history of preeclampsia | Diagnostic Test: blood sugar<br>* High and low risk women will undergo measuring fasting blood sugar after fasting 6-8hours with good hydration. then measuring blood sugar 1hrs and 2hrs postprandial. for patient with high results (FBS>95mg/dl, 1hr postprandial>126mg/dl, 2hrs postprandial >140mg/dl) should do HA1C if >5.6 consider it diabetic and dealing with whom positive as regard lifestyle management like diet and exercise 150 min. per week and whom not well controlled will be enrolled in pharmacological regimen as metformin. For whom measures normal will be tested by the same method at 20- 24 wks of gestation<br>|
| low risk pregnancy<br>average risk population like primigravida healthy women or those with normal obstetric history. | Diagnostic Test: blood sugar<br>* High and low risk women will undergo measuring fasting blood sugar after fasting 6-8hours with good hydration. then measuring blood sugar 1hrs and 2hrs postprandial. for patient with high results (FBS>95mg/dl, 1hr postprandial>126mg/dl, 2hrs postprandial >140mg/dl) should do HA1C if >5.6 consider it diabetic and dealing with whom positive as regard lifestyle management like diet and exercise 150 min. per week and whom not well controlled will be enrolled in pharmacological regimen as metformin. For whom measures normal will be tested by the same method at 20- 24 wks of gestation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| blood sugar percentage | High and low risk women will undergo measuring fasting blood sugar after fasting 6-8hours with good hydration. then measuring blood sugar 1hrs and 2hrs postprandial. for patient with high results (FBS>95mg/dl, 1hr postprandial>126mg/dl, 2hrs postprandial >140mg/dl) | 1 year |