Delivering Gestational Diabetic Mothers

OB/GYN News,  March 15, 2000  by Sharon Worcester

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SARASOTA, FLA. - Shoulder dystocia is a major concern in women with gestational diabetes--even when the baby is estimated to weigh less than 4,000 g, Dr. John F. Huddleston said at a perinatal symposium that was sponsored by Symposia Medicus.

"These babies are built like linebackers and they don't like to come out, except for their heads," said Dr. Huddleston, director of the division of maternal-fetal medicine at the University of Florida Health Science Center in Jacksonville.

He recommended using the McRobert's maneuver prophylactically during vaginal birth whenever there is a suspicion that shoulder dystocia is a possibility.

But if the patient has a diabetes diagnosis, the baby weighs over 4,000 g, and the size of the patient's pelvis is causing concern, there's nothing wrong with doing a C-section, he said at the symposium, also sponsored by Sarasota Memorial Hospital.

C-section may be appropriate for babies estimated to weigh more than 4,500 g, irrespective of the size of the pelvis, he added.

"We know how bad we are at these [weight] estimates, but we also know how bad Erb's palsy is," Dr. Huddleston said at the meeting.

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