Gestational diabetes mellitus--screening in a developing country.

All gravid women attending the antenatal clinic of the department of Gynaecology Unit-II, Civil Hospital Karachi and unbooked cases presenting in labour from October, 1986 to December, 1993, were included in the study. On the basis of risk factors for diabetes mellitus (DM), they were divided into 3 groups. Women in Group-I had family history of DM, bad obstetric history, congenitally malformed babies, polyhydramnios, obesity and macrosomia. Group-II included women with pregnancy induced hypertension (PIH) abruptio placentae, age > 30 years and multiple pregnancy. Group-III comprised of the pregnant women with no risk factors for DM. Screening of 4497 subjects from the antenatal clinic was performed and DM was diagnosed in 211 (12%) in Group-I, 11 (3%) in Group-II and 13 (0.6%) in Group III. Chi-square analysis demonstrated that frequency of DM was significantly higher (P < 0.001) in Group I and Group II as compared to Group III. Non-booked admissions numbered 7600, of these, DM was detected in 166 (20%) belonging to Groups-I and II, whereas, 38 (0.6%) were from Group-III. Screening was done by the O'Sullivan criteria. It was concluded that all pregnant women should be screened for DM. However, if financial constraints prevail, then women with high risk factors only should be subjected to screening.