title: Delivery (timing, route, peripartum glycemic control) in women with gestational diabetes mellitus.
abstract: OBJECTIVE
  To provide management guidelines for labour and delivery in women with gestational diabetes.
  
  
  METHODS
  A literature search was performed using the PubMed and Cochrane databases. Foreign societies guidelines were also consulted.
  
  
  RESULTS
  There is no additional information from recent studies that supports changing current French guidelines about timing of delivery in gestational diabetes. The incidence of shoulder dystocia is increased in women with gestational diabetes, especially when infants weigh more than 4500 g. Elective caesarean-section when the foetal weight is greater than or equal to 4250 to 4500 grams may reduce the risk of shoulder dystocia. Meticulous attention to avoiding maternal hyperglycaemia during labour can prevent neonatal hypoglycaemia. There is no significant role for x-ray pelvimetry in the management of gestational diabetes.
  
  
  CONCLUSIONS
  Management of labour and delivery in women with gestational diabetes will mainly depend on estimated foetal weight, especially when macrosomia is present.
authors.affiliation: Pôle d'obstétrique, maternité Jeanne-de-Flandre, CHRU de Lille, 59037 Lille cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Garabedian
authors.forename: P
authors.initials: P
authors.lastname: Deruelle
mesh_terms: D001720:Birth Injuries / Q000517:prevention & control; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods* / Q000592:standards; D016640:Diabetes, Gestational / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D010387:Pelvimetry; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012307:Risk Factors
chemical_list: D007328:Insulin