international federation of gynecology and obstetrics hip... · the international federation of...
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International Federation of Gynecology and Obstetrics
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WORKINGGROUPONHYPERGLYCEMIA INPREGNANCY(HIP)
Members:ProfessorMosheHod(Chair)DrHema Divakar (Co-Chair)DrHectorBolattiProfessorLuisCaberoRouraDrMaryD’AltonDrBlami DaoDrGernotDesoyeProfessorFidelma DunnDrYirguGebrehiwotFerede (Ex-officio)
DrAnilKapurDrTahirMahmoodDrMohamedMomtazDrDavidMcIntyreDrUmbeto SimeoniDrHuixia YangProfessorMarkHanson(Ex-officio)ProfessorGianCarloDiRenzo(Ex-officio)ProfessorGerardVisser (Ex-officio)
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FIGO GUIDELINES ONDIAGNOSIS,MANAGEMENT &CARE
OFGIRLS ANDWOMENWITHGESTATIONAL DIABETES
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MaternalObesity42 million pregnancies
MaternalHyperglycaemia~21 million pregnancies
MaternalAnaemia
56millionpregnancies
MaternalUndernutrition
26 million pregnancies
MaternalMalaria20millionpregnancies
~127 million live births
Maternalhypertensivedisorders
~7 million pregnancies
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127 millionlivebirths/year
~3to4milliondetectedandtreated
ReceivePostpartumfollowupandlifestyleadvice?
~21million/yearcomplicatedbyhyperglycaemia
India, China, Pakistan, Indonesia,Bangladesh,
Brazil, Mexico>65 million deliveries
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HIPisamajorglobalhealthproblem
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“…Facing a “Slow-Motion Disaster”UN Meeting on Non Communicable Diseases- Margaret Chan, Director-General, World Health Organization (WHO),Sept. 2011
• There is an increasing global crisis in NCD • NCD are associated with mortality, morbidity, and long-term disability• Two of three deaths globally are attributable NCDs
HIPisamajorglobalhealthproblem
Diagnosis and management may help turn the tide of the
Diabetes - NCD pandemic
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Dec2013 Oct2015FIGOExpertGrouponGDMestablished
Launchofguidelinesondiagnosis,managementandcare
Recommendationsgradedbyqualityof
evidence
Providesacallforactiontopolicymakers
Providesoptionsaccordingtoresource
setting
Identifieskeypointsof
intervention
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FIGOGDMguidelinesExecutivesummaryThetargetaudienceAssessmentofqualityofevidenceandgradingofrecommendationGestationalDiabetesMellitus(GDM)–Background,Definition,Epidemiology,PathophysiologyDiagnosingGestationalDiabetesMellitusGlucoseMeasurement:Technicalconsiderationsinlaboratoryandpointofcare(POC)testingManagementduringpregnancyPost-PartumManagementPreConceptionCareResearchPrioritiesAppendix
CurrentApproachestoGDMdiagnosisinselectedhighburdendevelopingcountriesGestationalDiabetesFormulasforCost-Effectiveness- GeDiForCE®ResearchPrioritiesinGestationalDiabetes
Recommendationsgradedbyquality
ofevidence
Providesacallforactiontopolicymakers
Providesoptionsaccordingto
resourcesetting
Identifieskeypointsof
intervention
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FIGOGDMguidance:Somehighlights1:DescribesanddifferentiatesGDM
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FIGO (WHO) Classification
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DIP&GDM=HIP
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Significanceforglobalhealth
FIGOBoxeshighlight
salientpoints
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AdvocatesUniversalTesting
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Universalcriteriafordiagnosis
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Recommendationfordiagnosis
Whilethisistheoptimalrecommendation,alternativesaregiveninacknowledgementoflimitationsfacedindiversesettings
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Technicalconsiderationsinlaboratoryandpointofcare(POC)testing
Standardsforlabtesting
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ManagementofGDM
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AssessingFetal wellbeing
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DeliveryforwomenwithGDM
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ManagementofGDM
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LifestyleManagement
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TreatmentofGDM
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Pre-conceptionandinter-pregnancy
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Postpartumcare
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Focusanddissemination
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Working Group onHyperglycaemia in Pregnancy (HIP)
Training, advocacy and evidence generation on hyperglycaemia in
pregnancy to reduce poor pregnancy outcomes; decrease maternal and neonatal morbidity and mortality; and cut future risk of diabetes &
cardio-vascular disease
Dec2013 Oct2015
Jan2016Oct2018
FIGOExpertGrouponGDMestablished
Launchofguidelinesondiagnosis,management
andcare
FIGOWorkingGrouponHIPinstated
ReportonsuccessesatFIGOWorldCongress
KeyMilestones
Awareness&Advocacy
CapacityBuilding&Training
Research
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Thenextthreeyears….
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WorkingGroupHyperglycaemiainPregnancy(HIP)
GOAL- Internationalorganizationsandkeygovernmentsimplementingtargetedcommunicationandadvocacystrategies
FIGOwillenagagewithmajororganisations(NGOs,UNOrganisations,professionalossociationsandgovernmentagencies)workinginthefieldofmaternalhealthtorecognizethathypeglycaemiainpregnancyisakeyissueimpactingmaternalandwomen'shealth,thatneedstobeaddressedaspartofSustainableDevelopmentGoal3onhealthandwelbeing.
AwarenessandAdvocacy
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WorkingGroupHyperglycaemiainPregnancy(HIP)
GOAL- Comprehensive,rolebasedtrainingprogramsbeingrolled-outto healthcareworkers;andtoimprovetheknowledge,skillsandattitudesof FIGOaffiliatesinthe
managementofHIP
CapacityBuildingandTraining
FIGOwill developandimplementcomprehensiveandcompetancybasedlearningresourcepackage(LRP)trainingonHIPtohealthcareworkersatalllevels.FIGOwillassistitsmemberorganizationstorolloutthetrainingonHIPusingthenewlydevelopedLRP.
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WorkingGroupHyperglycaemiainPregnancy(HIP)
GOAL:ToidentifyandimplementaresearchagendawhichwilladdressprioritygapsinknowledgeofHIP
FIGOwilldevelopaprioritizedresearchagendabasedonthebroadneedsidentifiedbytheFIGOrecommendations,createaresearchnetworkwhichwillworktowardsconductingresearchaimedataddressingprioritygaps.ThethreeyearworkplanfortheFIGOHyperglycemia inPregnancy(HIP)Groupisrelativelyshortforthedevelopment,funding,conductandanalysisofamajorindividualresearchproject(s).Nonetheless,theFIGOResearchNetworkwillachievesomeshort-termgoalstodemonstrateitskeycoordinatingroleinshapingtheglobalresearchagendaregardingHIP.TheInternationalFederationofGynecology andObstetrics(FIGO)InitiativeonGestationalDiabetes
Mellitus:APragmaticGuideforDiagnosis,ManagementandCarewhichaspublishedintheInternationalJournalofGynecology andObstetrics(IJGO)inOctober2015,
ResearchNetwork
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ØTAKE HOME MESSAGES
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ØHyperglycemia InPregnancyv The most common medical conditions women encounter during pregnancy
v Is associated with :
üLeading causes of maternal mortalityüHigher incidence of maternal morbidity
üHigher incidence of perinatal and neonatal morbidityüLater long term consequences for both mother and child
v Pregnancy offers a window of opportunity to:
üEstablish servicesü Improve health
üPrevent intergenerational transmission no communicable diseases
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ØFIGO recommendsAll pregnant women should be tested for hyperglycemia during pregnancy
vUniversal testing
vA one-step procedure
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The postpartum period Ø An important platform to initiate early preventive health for
mother and offspringwho are both at higher risk of:
v Future Obesity
v Metabolic Syndrome
v Diabetes
v Hypertension
v Cardiovascular Disorders
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Working Group onHyperglycaemia in Pregnancy (HIP)
Thankyouforlistening
www.figo.org
[email protected] [email protected] formoreinformation