title: Induction of labor at 38 to 39 weeks of gestation reduces the incidence of shoulder dystocia in gestational diabetic patients class A2.
abstract: The purpose of this study was to test the hypothesis that the incidence of shoulder dystocia could be reduced in insulin-requiring diabetic women by elective induction of labor at 38 to 39 weeks of gestation. A prospective study protocol in which labor was induced at 38 to 39 weeks of gestation in insulin-requiring diabetic women was executed between January 1, 1990, and July 31, 1994 (n = 96). The outcome was compared to the results of a previous protocol (years 1983 to 1989) in which the pregnancies were allowed to progress to spontaneous labor, unless fetal health became compromised (n = 164). The incidence of shoulder dystocia in patients in whom labor was electively induced at 38 to 39 weeks of gestation was 1.4% as compared to 10.2% in patients who delivered beyond 40 weeks' gestation (p < 0.05). No increase in cesarean section rate was demonstrated. We conclude that elective induction of labor is suggested for insulin-requiring diabetic women in order to reduce the incidence of shoulder dystocia.
authors.affiliation: Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Lurie
authors.forename: V
authors.initials: V
authors.lastname: Insler
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Hagay
mesh_terms: D000328:Adult; D000650:Amnion / Q000601:surgery; D016640:Diabetes, Gestational / Q000150:complications*; D004420:Dystocia / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007751:Labor, Induced; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors