Assessing the adherence of obstetricians towards postpartum diabetes screening guidelines: a pre- and post-intervention study at secondary care hospital in Karachi, Pakistan.

ABSTRACT

OBJECTIVE: To assess the adherence level of obstetricians towards postpartum diabetes screening guidelines. METHODS: The quasi-experimental pre- and post-intervention study was conducted from May 2014 to April 2015 at Aga Khan Hospital for Women-Karimabad, Karachi, and comprised all obstetricians practicing at the time. All the booked women with gestational diabetes delivered in the 6 months before refresher lecture (group 1) and those delivering in the 6 months following the intervention (group 2) were included. Data was analysed using SPSS 19. RESULTS: Of the 550 cases, 275(50%) each were in groups 1 and 2. All pregnant women had live-birth. The intervention made it thrice likely (95% confidence interval 7.83) that a physician advised postpartum oral glucose tolerance test. Caesarean section increased the chances of getting test advice almost 4 times (95% confidence interval 1.70, 9.10) compared to women who delivered vaginally. Women managed on insulin with / without metformin were 4 times likely to being advised the test compared to women managed on diet (confidence interval 1.00, 17.09). Full-time employees advised 7 times more than the visiting obstetricians (confidence inter val 1.33, 35.16). CONCLUSIONS: It is time for more strategic planning regarding patient education the benefits of detection of abnormal glucose tolerance in early postpartum period.