A TEAM of medical specialists are working towards ensuring that there is universal screening for gestational diabetes in Guyana which will protect women and their babies, countrywide, from pregnancy complications and even death.

Local Obstetrician and Gynaecologist Dr. Judy Hung told the newspaper that between December 2016 and June 2018, a total of 1,224 pregnant women have been screened for diabetes with 297 women found positive.

The screening is being done under a three-year programme which began in December 2016; it is being conducted in collaboration with the Georgetown Public Hospital Corporation (GPHC); the University of Toronto and the Guyana Diabetes Association.
The screenings were mostly conducted at the GPHC and two other health centres in Georgetown between 24 to 37 weeks of pregnancy; signs of gestational diabetes usually show up in the late second or third trimester.

Gestational diabetes is a condition in which a woman without diabetes develops high blood-sugar levels during pregnancy and, for about 50 per cent of women, the condition goes away after the baby is born.

Dr. Hung revealed that the consequences of gestational diabetes cannot only endanger the baby, but can also put the life of the pregnant mother at great risk. “When the mommy has diabetes the risk for the mommy can see her having a miscarriage; she can have congenital malformations in the baby; she can get pre-term labour; it increases the risk of you having hypertension in pregnancy; it increases the risk of having intra-uterine foetal death, which means that the baby would just die without any known cause,” she said, adding:

“What we worry about too is that the baby can grow very big [called] macrosomia, which can lead to caesarean section; it can lead to the mommy having shoulder dystocia, which is when the baby’s shoulders become lodged in the mommy and it’s very difficult for the mommy to deliver that baby; and it can cause postpartum haemorrhage.”

The five major complications found among the women screened and their percentages are hypertension, 47 per cent; caesarean section, 41 per cent; postpartum haemorrhage, 5 per cent; shoulder dystocia , 2.4 per cent and still birth, 1.3 per cent.

Prior to the screening being provided, Dr. Hung said that there was not much systematic gathering of information regarding the number of women with gestational diabetes, or suffering complications as a result.

However, the obstetrician and gynaecologist could now state: “Once you are diabetic you’re delivered a little bit earlier…we would be monitoring the baby more and that’s how came to do a lot of C-sections, because most of the C-sections that I noticed in my charts and the information selected were due to the baby having foetal distress, so we are now able to monitor more.”

The act of universal screening for gestational diabetes in pregnant women is nothing new, as it is being conducted in other countries around the world.
Speaking further on its endorsement, Dr. Hung said: “It is recommended by different international organisations like the American Congress of Obstetricians and Gynaecologists that all pregnant women should have a universal screening. Before, we never did screening like that, what we did was ask your history and if you had like a bad outcome in your pregnancy, they would then send you to do the screening,” Hung said.

With results coming in and more time still left on the programme, the team is hoping to gain the support of the government in expanding the screening to other regions, so that more women can have safer pregnancies and deliveries. “We want to have a sustainable screening programme to be done. So, once we have convincing figures that we can show the Ministry of [Public] Health that we should be doing universal screening for all pregnant women in Guyana, we can go to the Ministry of [Public] Health and [petition] for this screening to be done countrywide,” Dr. Hung said.

She further explained that the assistance of the ministry would be critical, as financial support is needed to sustain the project which is now being funded by other associations. Needed to do the screening is glucose; scales; personnel; special tubes in which to place blood samples and a centrifuge machine which spins the samples.

Speaking on the awareness of gestational diabetes, Dr. Hung stated: “Most women don’t know about diabetes in pregnancy. The test is a bit tedious, because you have to take three blood samples after fasting the night and then in the morning you have to drink the glucose…but in general you’re diagnosed early for diabetes; you’re monitored early and from our surveys, we’re able to see how many women think it has helped them.”

With this in mind, pregnant women who meet the criteria between 24 to 37 weeks of pregnancy are asked to take special interest in ensuring that they protect themselves and their babies from the condition and its effects.