Managing Labor and Delivery of the Diabetic Mother

Hen Y. Sela, MD; Itamar Raz, MD; Uriel Elchalal, MD

Disclosures

Expert Rev of Obstet Gynecol. 2009;4(5):547-554. 

In This Article

Expert Commentary

Suspected fetal macrosomia in a patient with either GDM or pre-GDM is related to both traumatic delivery and the rare but serious complication of brachial plexus injury. Planned Caesarean delivery in these cases seems to be indicated in order to avoid this complication. Conversely, in a well-controlled patient with a normal-sized fetus before term, vaginal delivery by either induction of labor or spontaneous delivery is a desirable and usually safe option. We believe that avoiding Caesarean delivery is an important and achievable goal, especially in such patients who can suffer from complications of Caesarean delivery; therefore, we advocate for frequent evaluation between 37 and 39 weeks of gestational age and timely induction of labor in cases where macrosomia seems to be likely.

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