الفهرس 
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Abstract
Gestational Diabetes Mellitus (GDM) is a glucose tolerance disorder that occurs or is diagnosed for the first time during pregnancy. It has been reported that GDM affects 1%–14% of all pregnancies, and that its incidence has been steadily rising.
HbA1c levels are quite useful for the evaluation of glucose control in both individuals and large populations, when used in an iterative fashion, measuring progress of glycemic control across periods of time and to follow the progress of a patient, it must be done keeping in mind the limitations of the HbA1c test. A specific application is the use of HbA1c measurements during pregnancy in patients with diabetes to determine the minimal perinatal risk for the mother and maximum health of the fetus. Stringent control prior to and during pregnancy decreases the risk of congenital malformations, overweight infants, as well as complications of pregnancy and delivery related to poorly managed glycemic control.
The aim of the present study was to investigate the relationship between glycemic control in first half of pregnancy by measuring mid pregnancy HbAlc and neonatal birth weight and amniotic fluid volume.
The present study was conducted on One hundred pregnant women with positive GDM screening test and normal OGTT attended the Obstetrics and Gynecology outpatient clinic at Tala General Hospital in the period between January 2015 to December 2016. For all participants, thorough history taking, good general and dermatological examination were done.
Results of the current study was as follow:
Pregnant women age ranged 18 to 45 year with mean of 30.5 21.73. 41 % of the pregnant women had above the average education. Duration of marriage was ranged 1.5 – 12 year with mean of 6.75 7.42. 28% of them had Consanguinity. 19 % of them had hypertension. 32 % of pregnant women had family history of diabetes. 4% of women had gestational diabetes in previous pregnancy and 97% of them hadn’t any intrauterine fetal death. Mean of maternal weight gain during prepregnancy (kg) was 13.5 4.84 and 166.5 37.47 for Oral glucose tolerance test (OGTT, mg/dl).
HbA1c% showed a mean of (4.6 0.31), in 1st trimester (before 13 week) and (3.89 0.11) in 2nd trimester (24:28 week), as well as (4.95 0.64) in 3rd trimester (28:36 week). Amniotic fluid index (AFI) showed a mean of 186 61.22. Gestational age at delivery (weeks) showed a mean of 39.15 3.04. Moreover, EFW (u/s) showed a mean of 3525 130.14.
Birth weight showed a mean of (3287 290). 89% of them had Apgar scores at 10 min equal or more than 7. 13% of them had Macrosomia, and 3% of them had Perineal tear.
A significant positive correlation was observed between:
HbA1c with BMI, AFI, EFW, GAD, and FHD. Also, BW with AFI and EFW. In addition, Apgar score with Gestational age at delivery.
A highly statistical significantly difference was observed between macrosomic and NBW groups regarding most of complications. As well as regarding gestational age at delivery, AFI, EFW and cesarean labor which were higher in macrosomic group, while, Apgar score was higher in NBW group.