[Prospective evaluation of our protocol for screening gestational diabetes by O'Sullivan's test]

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Maternal-Fetal Medicine

Background:

• Gestational diabetes mellitus (GDM) poses risks to both mother and fetus.
• Effective screening protocols are crucial for early detection and management of GDM.

Purpose of the Study:

• To prospectively evaluate the implementation and effectiveness of a specific protocol for screening diabetes during pregnancy.
• To identify areas for improvement in the protocol's application and patient management.

Main Methods:

• The study applied recommendations from the French National College for Obstetricians and Gynecologists.
• Screening involved the O'Sullivan test followed by a 100g oral glucose tolerance test (HGPO) if initial results exceeded 1.40 g/l.
• Protocol adherence and patient outcomes were prospectively monitored.

Main Results:

• Out of 780 patients, 628 (80.5%) were screened, with 39 (6.2%) diagnosed with gestational diabetes.
• Fetal ultrasound at 38 weeks was underutilized (25.8%).
• In the GDM subgroup, labor induction was 38.4%, cesarean delivery was 23%, and neonatal macrosomia was 20.5%.

Conclusions:

• The study highlights the need to enhance the application of the established gestational diabetes screening protocol.
• Reducing the time gap between the O'Sullivan test and HGPO is recommended.
• Optimizing protocol adherence can potentially improve management and reduce adverse pregnancy outcomes.