Effect of Implementation of Health Educational Guidelines on Maternal and Neonatal Outcomes among Women with Gestational Diabetes Mellitus

Document Type : Original Article

Authors

1 Assistant Lecturer of Maternity and Gynecological Nursing Dept., Faculty of Nursing, Tanta University, Tanta, Egypt.

2 Professor of Maternity and Gynecological Nursing Dept., Faculty of Nursing, Tanta University, Tanta, Egypt

3 Professor and Chairman of Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt.

4 Lecturer of Maternity and Gynecological Nursing Dept, Faculty of Nursing, Tanta University, Tanta, Egypt

Abstract

Abstract: Diabetes Mellitus (DM) is one of the most common medical complication that often affects pregnancy. Diabetes in pregnancy may be gestational (90%) or pregestational (10%) when it antedates pregnancy. Gestational Diabetes Mellitus (GDM) can lead to range of adverse pregnancy outcomes including; serious short and long-term maternal, fetal, as well as neonatal complications. Effective management with health educational intervention regarding GDM risks and its proper self-care measures will contribute to complications reduction and improve pregnancy outcomes for the woman and her offsprings. The aim of this study: was to evaluate the effect of implementation of health educational guidelines on maternal and neonatal outcomes among women with gestational diabetes mellitus. Subjects and method: The study was conducted at antenatal units of obstetric department at three settings; Tanta University Hospital, El-Menshawy General Hospital and El-Mabara Hospital. A convenient sample of 50 pregnant women diagnosed with GDM selected from the previously mentioned settings fulfilling the inclusive criteria were included in the study. Four tools were used for data collection: Tool I: A structured interview schedule that included (a). Socio-demographic characteristics, (b). Reproductive history, and (c). History of present pregnancy. Tool II: Anthropometric measurements, collected data about body mass index (BMI) of pregnant women. Tool III: Structured GDM Women's Knowledge Interview Schedule, included data related to Part a: assessment of women's knowledge about GDM and Part b: assessment of women's actual self-care measures regarding GDM. Tool IV: Outcome Assessment Tool: that included two parts Part I: Maternal outcome assessment sheet and Part II: Neonatal outcome assessment sheet. Results: The results of the present study revealed that fair and good level of knowledge as well as satisfactory level of self-care measures about GDM was reported among the study group after implementation of the education sessions. As well as significant improvement of maternal and neonatal outcomes were revealed among women of the study group who were less likely to develop maternal and neonatal complications after the implementation of the health education sessions in relation to time of onset labor, labor complications, length of hospital stay, neonatal complications, apgar score, birth weight, and also gestational age at delivery, as well as admission to neonatal intensive care unit. Conclusion: Health educational guidelines provided to the study group had improved their level of knowledge, awareness as well as self-care measures regarding GDM which consequently reflect positive effect on the maternal and neonatal outcomes in comparison with the control group who received only the routine hospital care. Therefore, the study recommended: Planning and developing antenatal health educational classes for all women to increase their awareness about the importance of early antenatal proper screening and effective GDM management to improve their pregnancy outcomes. Inaddition, refreshing courses and in-service training programs especially for newly appointed nurses can be successful in improving their knowledge and practices regarding GDM.
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