DM Pada Kehamilan

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RELATIONSHIP BETWEEN THREATENED

MISCARRIAGE AND GESTATIONAL


DIABETES MELITUS
Hee Joong Lee, Errol Norwitz and Banghyun Lee

Preceptor :
dr. Yusrizal, Sp.OG
Presented by:
Muhammad Riza Qadafi, S.Ked

FACULTY OF MEDICINE
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ABULYATAMA UNIVERSITY
READING MEURAXA HOSPITAL
BACKGROUND

Uteroplacental vessels
Considered to be
The most cause of
Vaginal bleeding

Threatened miscarriage occurs


In an estimated 14-20% of all pregnant woman
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MATERNAL
HYPERGLYCEMIA

Inadequate for the increase


insulin requirements during
pregnancy
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PROGESTERONE

Hypothesis :
Women with threatened miscarriage may have less insulin
resistance during the secong and third trimester of pregnancy

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So, what is the purpose of the study?

• To investigate whether threatened


miscarriage is a risk factor for GDM and

• To evaluate this relationship according to


the severity of glucose intolerance

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METHODS

Seoul or Uijeongbu
Data Source St. Mary’s Hospital at the Catholic
University of Korea

Periode

January 1, 2006 - October 31, 2013

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METHODS

Inclusion Pregnant women who underwent a two-step approach to diagnose


Criteria GDM

• Women who did not undergo a 100-g OGTT after a positive 50-g
OGCT
Exclusion • Who had other causes of vaginal bleeding
• Fetal anomalies
Criteria • Multifetal gestation
• Overt DM
• Non – Korean ethnicity

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METHODS
OGTT
Inclusion
Criteria OGCT


 
Exclusion
OGTT OGCT Fetal anomalies
Criteria

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The routine protocol
To diagnose GDM
OGTT Plasma glucose level >7,8 mmol/L
100-g At 1-h post glucose load without prior fasting

• Fasting glucose of ≥ 5,3 mmol/L


OGCT • ≥ 2 plasma glucose
• 1-h glucose of ≥ 10,0 mmol/L
measurements greater
50-g • 2-h glucose of ≥ 8,6 mmol/L
than following
• 3-h glucose ≥ 7,8 mmol/L

• OGCT = positif
Borderline • OGTT = negatif
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1567
Gestasional age
• Diet control 247 840
• Exercise GDM Normal Last menstrual Crown-rump
• Careful glucose 480 period (LMP) Length (CRL)
monitoring Border
• line

Amount of bleeding
Same routine as
healthy pregnant
woman

light heavy

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Intrauterine Crescent-shaped
Hematom echolucent

SGA <10
persentil

AGA 10 – 90
BMI persentil

LGA > 90 persentil

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RESULT
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Discussion

GDM Decreased in GDM


Miscarriage

The birth weight and the incidence rate of


Inverse correlation SGA, LGA, or macrosomia were ubchanged
in women with GDM and maternal
hyperglycemia

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CONCLUSION :

This study demonstrate


That miscarriage is associated with decreased risk of
GDM and the severity of glucose intolerance in korean
women. Additional studies are warranted to understand the
pathophysiologic mechanisms that might exist between these
frequent complications of pregnancy

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