الفهرس 
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Abstract
Although, pregnancy is a normal phenomenon, complications can occur. Diabetes Mellitus (DM) is one of the most common medical complication that often affects pregnancy. Diabetes in pregnancy can be classified as gestational diabetes (90%) or pregestational (10%). Gestational diabetes mellitus (GDM) is a type of diabetes characterized by abnormal glucose metabolism with the onset of first recognition during pregnancy particularly during the third trimester and disappears after delivery. GDM is strongly associated with adverse outcomes, it has serious short- and long-term complications to the mothers, fetuses, as well as newborn. Thus, a major part of GDM nursing management involves educating patients regarding GDM risks and its proper self-care management about; diet, exercise, self-blood glucose monitoring and insulin treatment. Health education plays an important role in increasing women’s knowledge and awareness about GDM that will be translated to improve their self-care measures and increase their commitment with the care regimen, which ultimately will contribute to complications reduction. The maternity nurse plays a major role in the health education which is a step for better management of GDM to improve pregnancy outcomes for the woman and her offsprings. Therefore this study aimed at evaluating the effect of implementation of health educational guidelines on maternal and neonatal outcomes among women with gestational diabetes mellitus. To fulfill the study aim:- Settings: The study was conducted at antenatal units of obstetric department at three settings; Tanta University Hospital, El-Menshawy General Hospital and El-Mabara Hospital. Subjects: A convenient sample of 50 pregnant women diagnosed with GDM were included in the study and fulfilling the inclusive criteria, pregnant women aged range (18-38) years, gestational weeks between (28-34) at their 3rdtrimester of pregnancy, both primigravida and multigravida, diagnosed only with GDM, singleton pregnancy, normal course of pregnancy (free from other medical and obstetrical complications and also women willing to participate in the study.The sample was divided into two equal groups; study group (consisted of 25 pregnant woman diagnosed with GDM whom the health educational guidelines were provided to them) and control group (consisted of 25 pregnant woman diagnosed with GDM who received routine hospital care).Those women were selected from antenatal units in each of the previously mentioned settings. Tools for data collection: To achieve the aim of the study the following tools were used: Tool I: Structured interview schedule, included data related to three parts as following: a. Biosocio-demographic characteristics as; age, education, occupation, residence and income, b. Reproductive history such as; gravidity, parity, number of abortions, presence of previous obstetrical complications, past history of GDM, antenatal booking and attendance of antenatal care classes related to GDM and c.History of present pregnancy as; detection time of GDM, method of treatment, presence of GDM risk factors and complications and also previous hospitalization due to GDM. Tool II: Anthropometric measurements; collected data about body mass index (BMI) which included height and weight of pregnant women. Tool III: Structured GDM Women’s Knowledge Interview Schedule: It included data related to Part a: assessment of women’s knowledge regarding GDM as; definition, risk factors, signs and symptoms, effect of GDM on pregnancy including; maternal/fetal-neonatal complications, therapeutic management regimen and women’s sources of GDM knowledge. Part b: assessment of women’s actual self-care measures regarding GDM as; selfblood glucose monitoring, self-injection of insulin, self-care measures for hypoglycemia/hyperglycemia, dietary intake, exercise, personal hygienic measures(foot& teeth care) and also self-care measures after birth as breastfeeding and follow-up for assessment of blood glucose level. Tool IV: Outcome Assessment Tool: It included data after assessment of maternal and neonatal outcomes during delivery for the studied groups contains two parts. Part I: Maternal outcome assessment sheet (Presence of maternal distress, mode of rupture of membranes-spontaneous and/or artificial, time of rupture of membranes-pre-mature or mature, type of delivery-normal or cesarean section, occurrence of complications during labor related to GDM as (pre-eclampsia, preterm labor obstructed labor, cord prolapse, obstetric trauma, postpartum hemorrhage), and also length at hospital stay and Part II: Neonatal outcome assessment sheet: included assessment of viability status-alive or stillborn, abnormal apgar score, need for resuscitation and oxygen administration, visible congenital malformation, birth weight measurements (macrosomia), gestation at delivery, neonatal complications such as; birth trauma ”shoulder dystocia”, neonatal hypoglycemia or jaundice, signs of respiratory distress syndrome, admission to neonatal intensive care unit, and also length of stay at hospital. The results of the current study can be summarized as follows: Concerning the socio-demographic characteristics of women: The age range of the women was (21-38) years old and the mean age of women among the study and control groups were (31.16+4.61 and 33.88+5.43 respectively), approximate percentage half ( 56% & 48%) for each group either were from rural areas, or finished secondary/ diplom education, about each one third (28% & 32%) had university education and about three quarters (76% & 72%) for each of them had medium income respectively.