Biochemical Management of Gestational Diabetes Mellitus in Antenatal Clinics in Imo State: A Professional Review

Gestational diabetes mellitus is associated with significant maternal and neonatal morbidity, and its biochemical management including screening protocols, glycaemic monitoring standards, and postnatal follow-up biochemistry in Imo State antenatal facilities requires professional review to identify gaps and improvement opportunities. This study conducts a professional review of gestational diabetes mellitus biochemical management at six antenatal clinics in Owerri, Orlu, and Okigwe LGAs of Imo State. A structured professional review methodology combined clinical record audit of three hundred and eighty antenatal records, interviews with twenty-two obstetricians and midwives, and a patient survey administered to eighty women with documented gestational diabetes diagnosis. Biochemical management was evaluated against the International Federation of Gynecology and Obstetrics gestational diabetes diagnostic and monitoring standards. Results reveal significant gaps in screening protocol implementation: only 34 percent of records documented universal or risk-stratified glucose screening, while 66 percent of gestational diabetes diagnoses were opportunistic. The seventy-five gram oral glucose tolerance test was the documented diagnostic tool in 61 percent of confirmed cases but results were recorded incompletely in many records. Self-monitoring of blood glucose was recommended to only 28 percent of confirmed gestational diabetes patients. Postnatal glucose tolerance test six to twelve weeks after delivery was documented in fewer than 12 percent of gestational diabetes patients, representing a critical missed opportunity for type 2 diabetes prevention. Recommendations address protocol standardization, patient education materials, and postnatal follow-up systems. Keywords: gestational diabetes, biochemical management, antenatal care, OGTT, Imo State.