Compliance with the Gestational Diabetes Mellitus protocol in pregnant women from Jinotega

Abstract

Gestational diabetes mellitus (GDM) is a common complication during pregnancy, characterized by glucose intolerance that first appears in the second or third trimester. The aim of this study was to determine the level of compliance with the care protocol for Gestational Diabetes Mellitus (GDM) in pregnant women treated at Victoria Motta Hospital, Jinotega, during 2020–2021. The study was descriptive, observational, retrospective, and cross-sectional. The sample consisted of 87 patients selected through random probability sampling. Data was processed using SPSS, and protocol compliance was assessed through a checklist. The results showed that the predominant age group was 20 to 34 years (63.2%), with most patients from rural areas (59.8%), having primary education (46%), and being housewives (92%). A total of 73.6% had a body mass index ≥25, which was identified as the main risk factor. GDM was diagnosed primarily between the 24th and 28th weeks of gestation (35.6%). Only 2.3% of medical records fully complied with the established protocol. Daily glucose monitoring, the indication of glycemic targets, and multidisciplinary management were scarce. Despite the documentation shortcomings, all patients showed clinical improvement. Mild maternal complications and minimal fetal complications were identified. The study reveals low compliance with the institutional protocol, highlighting the need to strengthen the implementation of guidelines in high-risk obstetric care, especially for GDM.