‘Detection and Management of Diabetes during Pregnancy in Low Resource Settings: Insights into Past and Present Clinical Practices’ by Bettina Utz, Alexandre Delamou, Loubna Belaid and Vincent De Brouwere
Timely and adequate treatment is important to limit complications of diabetes affecting pregnancy, but there is a lack of knowledge on how these women are managed in low resource settings. Objective of this study was to identify modalities of gestational diabetes detection and management in low and lower middle income countries. A scoping review of published literature and searched the databases PubMed, Web of Science, Embase, and African Index Medicus was conducted. All articles published until April 24, 2016, containing information on clinical practices of detection and management of gestational diabetes irrespective of publication date or language were included for the review. Total 23 articles mainly from Asia and sub-Saharan Africa were identified. The majority of studies were conducted in large tertiary care centers and hospital admission was reported in a third of publications. Ambulatory follow-up was generally done by weekly to fortnightly visits, whereas self-monitoring of blood glucose was not the norm. The cesarean section rate for pregnancies affected by diabetes ranged between 20% and 89%. Referral of newborns to special care units was common. The variety of reported provider practices underlines the importance of promoting latest consensus guidelines on GDM screening and management and the dissemination of information regarding their implementation.
Maternal mortality measurement remains a critical challenge, particularly in low and middle income countries (LMICs) where little or no data are available and maternal mortality and morbidity are often the highest in the world. Despite the progress made in data collection, underreporting and translating the results into action are two major challenges that maternal death surveillance systems (MDSSs) face in LMICs. This paper presents a protocol for a scoping review aimed at synthesizing the existing models of MDSSs and factors that influence their completeness and usefulness. Read the full paper by clicking the title above.