problems that occur during delivery

Last reviewed 09/2022

There are several problems associated with a diabetic's delivery:

• failure to progress due to foetal macrosomia

• shoulder dystocia:
• the foetal head may be delivered without problems but in a macrosomic foetus the shoulders are wider than the head and may become caught at the pelvic brim
• this is an obstetric emergency associated with a high foetal morbidity and occasional mortality

• blood glucose control during and after labour:
• care is required to avoid hypoglycaemia immediately after labour as insulin resistance falls rapidly
• the insulin dose must be reduced to about 50% of pregnant levels immediately after delivery