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

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.