Diabetes in Pregnancy: Timing and Mode of Delivery

  • Gianpaolo Maso
  • Monica Piccoli
  • Sara Parolin
  • Stefano Restaino
  • Salvatore Alberico
Diabetes and Pregnancy (CJ Homko, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Diabetes and Pregnancy

Abstract

Diabetes in pregnancy represents a risk condition for adverse maternal and feto-neonatal outcomes and many of these complications might occur during labor and delivery. In this context, the obstetrician managing women with pre-existing and gestational diabetes should consider (1) how these conditions might affect labor and delivery outcomes; (2) what are the current recommendations on management; and (3) which other factors should be considered to decide about the timing and mode of delivery. The analysis of the studies considered in this review leads to the conclusion that the decision to deliver should be primarily intended to reduce the risk of stillbirth, macrosomia, and shoulder dystocia. In this context, this review provides useful information for managing specific subgroups of diabetic women that may present overlapping risk factors, such as women with insulin-requiring diabetes and/or obesity and/or prenatal suspicion of macrosomic fetus. To date, the lack of definitive evidences and the complexity of the problem suggest that the “appropriate” clinical management should be customized according with the clinical condition, the type and mode of intervention, its consequences on outcomes, and considering the woman’s consent and informed decisions.

Keywords

Birth injuries Cesarean delivery Delivery Excessive fetal growth Gestational diabetes Induction of labor Labor Macrosomia Obesity Pregestational diabetes Pregnancy Review Shoulder dystocia Type 1 diabetes Type 2 diabetes 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Gianpaolo Maso, Monica Piccoli, Sara Parolin, Stefano Restaino, and Salvatore Alberico declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Gianpaolo Maso
    • 1
  • Monica Piccoli
    • 1
  • Sara Parolin
    • 1
  • Stefano Restaino
    • 1
  • Salvatore Alberico
    • 1
  1. 1.Department of Obstetrics and GynecologyInstitute for Maternal and Child Health – IRCCS Burlo GarofoloTriesteItaly

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