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Best practice guidelines to monitor and prevent morbidity and mortality related to gestational diabetes mellitus in Addis Ababa, Ethiopia / Dintlhakaelo tsa tiriso e e gaisang ya go tlhokomela le go thibela ditshwaetsego tsa bomme le dintsho tse di golaganeng le bolwetsi jwa sukiri (diabetis mellitus) jwa baimana kwa Addis Ababa, EthiopiaGetahun Sinetsehay Alemayehu 08 1900 (has links)
Text in English with abstracts and keywords in English and Setswana / Aim: The purpose of the research was to determine the magnitude and factors associated
with gestational diabetes mellitus (GDM), and to explore the experiences of
gynaecologists/obstetricians and midwives in the monitoring and prevention of GDM- related
adverse maternal outcomes in order to propose best practice guidelines which may be
implemented to overcome the problem.
Methods: A concurrent mixed methods design was used. Participants for the quantitative
study were selected using systematic random sampling, with purposive sampling being used
for the qualitative part of the study. A total of 2000 medical records were reviewed using a
checklist, in addition to which 7 gynaecologists/obstetricians and 12 midwives were
interviewed using an in-depth interview guide. Descriptive and inferential statistics were used
for the quantitative part, while Colaizzi’s manual qualitative data analysis method wasused
for the qualitative part of the study.
Findings: The magnitude of GDM was found to be 2.2%. Age and family history of diabetes
mellitus were found to be factors associated with GDM (at p < 0.001). Other factors such as
obesity, previous GDM, previous history of fetal macrosomia and multiple gestations were
identified by respondents as factors related with GDM. In addition, the study explored the
experiences of health professionals (HPs) in the monitoring and prevention of adverse maternal outcomes related to GDM, with the results showing some differences in screening
and diagnostic techniques. It was also shown that lifestyle modification (physical exercise,
diet management) and medication were utilised for managing women with GDM. In this
regard, all the HPs agreed that creating awareness is the best intervention for preventing
GDM as well as its adverse maternal outcomes.
Conclusions: The magnitude of GDM is increasing, and much needs to be done to draw
attention to the burden that GDM places on the health of pregnant women and the public.
Since GDM is not considered a public health problem, little is being done to monitor the
condition and its adverse maternal outcomes. It is hoped that the best practice guidelines
developed from this research study may assist in reducing the adverse maternal outcomes
of GDM in Ethiopia / Maikaelelo: Lebaka la patlisiso e ne e le go tlhotlhomisa go nna teng le mabaka a a
golaganeng le bolwetsi jwa sukiri jwa baimana (GDM), le go tlhotlhomisa maitemogelo a
dingaka tsa malwetsi a basadi (gynaeologists/ obstetricians) le babelegisi mo go
tlhokomeleng le go thibeleng ditlamorago tse di maswe mo baimaneng tse di amanang le
GDM gore go tshitshinngwe dintlhakaelo tse di gaisang tse di ka diragadiwang go fenya
bothata.
Mekgwa: Go dirisitswe thadiso ya mekgwa e e tlhakantsweng. Banni-le-seabe ba
thutopatlisiso e e lebelelang dipalopalo ba ne ba tlhophiwa go diriswa go tlhopha sampole
ka go se latele thulaganyo, mme go tlhopha sampole ka maikaelelo go ne ga diriswa mo
karolong ya thutopatlisiso e e lebelelang mabaka. Go sekasekilwe palogotlhe ya direkoto tsa
kalafi tse 2 000 go diriswa lenanetshekatsheko, mme mo godimo ga moo, go ne ga nna le
dipotsolotso le dingaka tsa malwetsi a basadi di le supa le babelegisi ba le 12 go diriswa
kaedi ya dipotsolotso tse di tseneletseng. Dipalopalo tse di tlhalosang le tse go sweditsweng
ka tsona di ne tsa diriswa mo karolong ya dipalopalo ya thutopatlisiso, fa go dirisitswe
mokgwa wa ga Colaizi wa tokololo ya data ya mabaka mo karolong e e lebelelang mabaka.
Diphitlhelelo: Go nna teng ga GDM go ne ga fitlhelwa e le 2.2%. Dingwaga le hisetori ya bolwetsi jwa sukiri ya baimana mo lelapeng di fitlhetswe e le dintlha tse di golaganeng le
GDM (ka p < 0.001). Dintlha dingwe, jaaka go nona phetelela, GDM mo nakong e e fetileng,
go nna teng ga macrosomia ya masea mo nakong e e fetileng le boimana jwa masea a feta
bongwe di ne tsa supiwa ke batsibogi jaaka dintlha tse di golaganeng le GDM. Go tlaleletsa
foo, thuto e ne ya sekaseka maitemogelo a baporofešenale ba boitekanelo (HPs) mo
tlhokomelong le thibelo ya ditlamorago tse di sa siamang mo baimaneng tse di golaganeng
le GDM, mme dipholo di bontshitse dipharologano dingwe mo dithekeniking tsa
go sekirina le go phekola. Go bonagetse gape gore phetolo ya mokgwa wa botshelo
(katiso ya mmele, tsamaiso ya mokgwa wa go ja) le kalafi di ne tsa diriswa go laola bolwetsi
jwa basadi ba ba nang le GDM. Mo lebakeng le, baporofešenale botlhe ba boitekanelo ba
ne ba dumelana gore go dira temoso ke tsereganyo e e gaisang ya go thibela GDM ga
mmogo le ditlamorago tsa yona tse di sa siamang mo baimaneng.
Ditshwetso: Go nna teng ga GDM go a oketsega, mme go tshwanetse go dirwa go le gontsi
go lemosa ka mokgweleo o bolwetse jono bo o bayang mo boitekanelong jwa baimana le
setšhaba. Ka ntlha ya gore GDM ga e kaiwe jaaka bothata jwa boitekanelo jwa setšhaba,
ga go dirwe go le kalo go tlhokomela bolwetsi le ditlamorago tsa jona tse di sa siamang mo
baimaneng. Go solofelwa gore dintlhakaelo tsa tiriso e e gaisang tse di dirilweng mo
thutopatlisisong eno di ka thusa go fokotsa ditlamorago tse di sa siamang tsa GDM mo
baimaneng kwa Ethiopia. / Health Studies / D. Litt. et Phil. (Public Health)
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