Adherence to Clinical Practice Guidelines during Antenatal Management of Gestational Diabetes Mellitus: An Integrative Review

Abstract

The number of pregnant women affected by gestational Diabetes (GDM) is increasing globally with an estimated prevalence as high as 15%. Gestational Diabetes Miletus is associated with birth complications for women and newborn, includes development of type II diabetes, preeclampsia during pregnancy, increasing the risk of fetal loss, stillbirth and perinatal death. An integrative literature review applied, systematic search from different data base obtained from international and middle east countries to assess adherence level of guidelines. Clinical guidelines are set to ensure and assure homogeneity as well as the quality of provision of care. National and international consensus has yet to be achieved in the management of diabetes in pregnancy, adherence of recommended antenatal care content to a minimum level appears to be unmet. Complete provider adherence to first antenatal guidelines was 48.1%, Guideline dissemination alone does not change practice; assessment of barriers/enablers and implementation is important. Guidelines are useless when they are not used or adhered to. Each guideline needs an Appendix on how adherence has to be measured, there is a need for some uniformity across guidelines to measure adherence. Diabetes management is an essential constituent to prevent prognosis of diabetes complications.

Screening and nursing management of gestational diabetes in Ghana: Evidence-based recommendations

“…Although internationally, guidelines on screening and management of GDM are available that may be used to guide midwives in their practices, these are not contextualized and translated to accommodate the Ghanaian context [ 9 ]. In line with the findings of an integrative review regarding clinical practice guidelines' adherence during the management of GDM [ 10 ], the researcher's observations at the time of the current study suggested that screening and nursing management of GDM in the antenatal, intra partum and postpartum periods in Ghana is often done inconsistently and not according to the latest evidence. Thus, a need was identified for developing evidence-based recommendations (hereafter referred to as ‘recommendations’) in order to assist midwives in providing evidence-based care regarding the screening and management of GDM in Ghana.…”

Adherencia a guías de manejo de emergencias obstétricas en muerte materna, Hospital Carlos Monge Medrano 2020

“…El 2018, Nisreen I. y col. Jordania; investigaron Adherencia a las GPC durante el manejo prenatal de diabetes mellitus gestacional, encontrando adherencia completa del proveedor a pautas prenatales (48,1%) 7 . El 2018, Grisolle Ortiz y col. Colombia; reportan Adherencia a guías de atención de control prenatal, como media (86%) y aceptable (85.8%) adherencia 8 .…”