Dr Priyamvada Kumar1, Ms Champika Pattullo1, Dr Jade Eccles-Smith1, Dr. Penny Wolski1
1Royal Brisbane and Women's Hospital, Herston, Australia
Biography:
Priyamvada Kumar is a junior doctor interested in Obstetrics and Gynaecology at Royal North Shore Hospital currently pursuing her Certificate of Women’s Health. She is dedicated to advocating for women in medicine as the representative of the Young Australian Women in Medicine Council, and is actively engaged medical student teaching.
Abstract:
Objective: Gestational Diabetes Mellitus (GDM) is a complication of pregnancy which requires multidisciplinary care and has had a rising incidence in Australia (1). We describe antenatal models of care that GDM patients received in a tertiary hospital in Queensland, Australia, and maternal and pregnancy outcomes.
Methods: Antenatal models of care were outlined through a survey with the maternity diabetes educators. A retrospective audit of n=40 patients with GDM was performed. Data were collected through electronic medical records and reviewed for maternal and pregnancy outcomes.
Results: Eight models of care were identified and classified into low, all risk and high-risk. Most patients remained in their original models of care following GDM diagnosis. Five patients (33.33%) from low-risk and n=2 patients (10%) from all-risk groups transitioned to tertiary care following GDM diagnosis. Patients in tertiary models of care had the highest number n=5(100%) of GDM medical management and the highest rate of elective caesarean sections and serial ultrasounds in pregnancy. Lower-risk models of care had fewer inductions of labour offered. Perineal trauma was higher in groups which delivered vaginally but were not offered induction of labour across all risk groups. In total there were two (5%) patients who developed pre-eclampsia, n=1(2.5%) post-partum haemorrhage and n=1(2.5%) shoulder dystocia.
Conclusions: Most patients remained in their antenatal models of care following a diagnosis, there was a higher rate of low-risk group patients transitioning to escalated models of care in comparison to all-risk groups. Tertiary models of care had an increased rate of medical management, serial ultrasounds, and elective caesarean sections in pregnancy compared with low-risk models of care.
Keywords
gestational diabetes
References
1. McLean A;Kirkham R;Campbell S;Whitbread C;Barrett J;Connors C;Boyle J;Brown A;Mein J;Wenitong M;McIntyre HD;Barzi F;Oats J;Sinha A;Maple-Brown L; (no date) Improving models of care for diabetes in pregnancy: Experience of current practice in far North Queensland, Australia, Frontiers in public health. Available at: https://pubmed.ncbi.nlm.nih.gov/31380333/ (Accessed: 01 August 2023).