Abstract

Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant and Hypertension during pregnancy is defined as a diastolic blood pressure of 90 mmHg or greater or a single diastolic blood pressure above 110 mm Hg.

The objectives were made to detect gestational diabetes and hypertension among pregnant women follow by to determine the relationship between gestational diabetes and hypertension among pregnant women and lastly to determine the relationship between 1st, 2nd, 3rd trimester of pregnancy with respect of gestational diabetes and hypertension.

The study was a cross sectional study and data was collected using structured questionnaires also specimen were collected and analyses in the laboratory. Participants include all pregnant women attending ante natal care at the solidarity hospital Buea, a total of 100 participants were involved in the study.

Out of the 100 participant only 7 (7.0%) women show positive for gestational diabetes mellitus, mean while the rest 93 (93.0%) show negative for the test follow by 1 (1.0%) woman show positive for gestational hypertension, while the rest 99 (99.0%), Just 1 participant was presented with both gestational diabetes and hypertension, and the last objective show 4 positive for 2nd trimester and 3 positive for 3rd trimester for gestational diabetes meanwhile for gestational hypertension just 1 positive for 3rd trimester, conclusively, this study therefore concludes that the is no significant relationship between gestational diabetes and hypertension during pregnancy based on the result since the study was done at a certain time (June to July).Recommending to this study was that the hospital should make sure that all pregnant women should be check at their 1st trimester so that early detection will be managed.

CHAPTER ONE

INTRODUCTION

1.1 Background

Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Some women have more than one pregnancy affected by gestational diabetes. Gestational diabetes usually shows up in the middle of pregnancy. Doctors most often test for it between 24 and 28 weeks of pregnancy.

Gestational Diabetes Mellitus (GDM) occurs when there is a glucose intolerance that is first detected during pregnancy. It is a form of hyperglycemia (Buchanan and Xiang, 2005). The aetiology of the condition is unknown but there have been many suggestions as to the cause of it, including autoimmune destruction of the beta; pancreatic cells and the possibility of a genetic predisposition to the condition.

Hormones that are produced in pregnancy help contribute to the insulin resistant state which characterizes diabetes. In recent years, there has been an increase in the cases of Obesity and this is a risk factor for both Diabetes Mellitus and Cardiovascular Disease. The intrauterine environment can affect fetal programming and development. This essay will look into how the placenta and its products can affect the insulin resistant state and how this resistance effects programming as well as the role of oxidative stress and inflammation in making the offspring more susceptible to cardiovascular disease.

GDM is a state of insulin resistance which disturbs the intrauterine environment and can lead to accelerated fetal growth (Radaelli et al, 2003).It effects approximately 7% of pregnant women with approximately 200,000 cases seen each year (Schillan-Koliopoulos and Guadagno, 2006).

The term GDM is applicable when the onset is during the second and third terms of the pregnancy, but it does not exclude the possibility that the insulin resistance was undiagnosed before the pregnancy. If this is the case and is found to occur in the earlier stages of pregnancy then the mother should be treated the same as mothers who are known to have diabetes before pregnancy (Metzger and Coustan, 1998).

High blood pressure is also known as hypertension. Blood pressure is the amount of force exerted against the walls of the arteries as blood flows through them.

If a person has high blood pressure it means that the walls of the arteries are receiving too much pressure repeatedly – the pressure needs to be chronically elevated for a diagnosis of hypertension to be confirmed. In medicine chronic means for a sustained period; persistent.

In the USA approximately 72 million people have high blood pressure – about 1 in every 3 adults, according to the National Heart Lung and Blood Institute. The National Institutes of Health (NIH) estimates that about two-thirds of people over the age of 65 in the USA have high blood pressure.

In the UK, The National Health Service estimates that about 40% of British adults have the condition. Measuring blood pressure, what is high blood pressure? Causes and diagnosis, and Treatments and prevention.

The heart is a muscle that pumps blood around the body constantly – during every second of our lives. Blood that has low oxygen levels is pumped towards the lungs, where oxygen supplies are replenished. The oxygen rich blood is then pumped by the heart around the body to supply our muscles and cells. The pumping of blood creates pressure – blood pressure associated with a high incidence of essential hypertension (Redman et al, 1992). Once again insulin resistance may be a unifying factor. However, there is no direct clinical evidence that gestational diabetes predisposes to future hypertension.

Hypertension during pregnancy is defined as a diastolic blood pressure of 90 mmHg or greater on two occasions more than 4 hours apart or a single diastolic blood pressure above 110 mm Hg.

1.2 Problem Statement

The leading causes of death among pregnant women in Cameroon are severe bleeding, hypertension, gestational diabetes etc. Despite the effort made by the WHO program works with its partners towards maternal and child health by providing technical guidelines, training materials on the management of obstetric emergencies, best practice protocols on female genital injury management and obstetric safety, and data on the capacity of district hospitals to provide emergency obstetric care but pregnant women still suffer from this complication so it was necessary for the study to be carried out by researchers to investigate the relationship between gestational diabetes and hypertension among pregnant women at Solidarity Hospital in Buea.

1.3 Hypothesis

There is no significant relationship between gestational diabetes and hypertension, affecting pregnant women attending Solidarity Hospital Buea.

1.4 Significance of the Study

This study will help to come out with clear relationship between gestational diabetes and hypertension among pregnant women, attending solidarity hospital in Buea. This study will best help the physician to come out with the possible ways to solve the complication and to prevent death among pregnant women.

1.5 Research Objectives

1.5.1 General Objective

This study is design to investigating the relationship between gestational diabetes and hypertension among pregnant women attending solidarity hospital Buea.

1.5.2 Specific objectives

1. To detect gestational diabetes using glucometer and hypertension using BP machine among pregnant women.
2. To determine the relationship between gestational diabetes and hypertension among pregnant women.
3. To determine the relationship between 1st, 2nd, 3rd trimester of pregnancy with respect of gestational diabetes and hypertension.

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