Diabetes in pregnancy: Timing and mode of delivery

Gianpaolo Maso, Monica Piccoli, Sara Parolin, Stefano Restaino, Salvatore Alberico

Research output: Contribution to journalArticle

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.

Original languageEnglish
Article number506
JournalCurrent Diabetes Reports
Volume14
Issue number7
DOIs
Publication statusPublished - 2014

Fingerprint

Pregnancy in Diabetics
Dystocia
Stillbirth
Gestational Diabetes
Informed Consent
Fetus
Obesity
Mothers
Insulin

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

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine
  • Medicine(all)

Cite this

Diabetes in pregnancy : Timing and mode of delivery. / Maso, Gianpaolo; Piccoli, Monica; Parolin, Sara; Restaino, Stefano; Alberico, Salvatore.

In: Current Diabetes Reports, Vol. 14, No. 7, 506, 2014.

Research output: Contribution to journalArticle

Maso, Gianpaolo ; Piccoli, Monica ; Parolin, Sara ; Restaino, Stefano ; Alberico, Salvatore. / Diabetes in pregnancy : Timing and mode of delivery. In: Current Diabetes Reports. 2014 ; Vol. 14, No. 7.
@article{e4a6c51bd2474197ad3c9d6d2ee0896e,
title = "Diabetes in pregnancy: Timing and mode of delivery",
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",
author = "Gianpaolo Maso and Monica Piccoli and Sara Parolin and Stefano Restaino and Salvatore Alberico",
year = "2014",
doi = "10.1007/s11892-014-0506-0",
language = "English",
volume = "14",
journal = "Current Diabetes Reports",
issn = "1534-4827",
publisher = "Current Medicine Group",
number = "7",

}

TY - JOUR

T1 - Diabetes in pregnancy

T2 - Timing and mode of delivery

AU - Maso, Gianpaolo

AU - Piccoli, Monica

AU - Parolin, Sara

AU - Restaino, Stefano

AU - Alberico, Salvatore

PY - 2014

Y1 - 2014

N2 - 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.

AB - 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.

KW - Birth injuries

KW - Cesarean delivery

KW - Delivery

KW - Excessive fetal growth

KW - Gestational diabetes

KW - Induction of labor

KW - Labor

KW - Macrosomia

KW - Obesity

KW - Pregestational diabetes

KW - Pregnancy

KW - Review

KW - Shoulder dystocia

KW - Type 1 diabetes

KW - Type 2 diabetes

UR - http://www.scopus.com/inward/record.url?scp=84901548817&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901548817&partnerID=8YFLogxK

U2 - 10.1007/s11892-014-0506-0

DO - 10.1007/s11892-014-0506-0

M3 - Article

C2 - 24811363

AN - SCOPUS:84901548817

VL - 14

JO - Current Diabetes Reports

JF - Current Diabetes Reports

SN - 1534-4827

IS - 7

M1 - 506

ER -