Does induction of labour prevent shoulder dystocia?

  •  Early IOL for women with suspected fetal macrosomia,who do not have gestational diabetes,does not improve either maternal or fetal outcome.(Evid level 4)
  • In women with gestational diabetes, the incidence of SD is reduced with early IOL.(Evid level 2+)
  • The NICE diabetes guideline recommends that pregnant women with diabetes who have a normally grown fetus should be offered elective birth through IOL,or by elective CS if indicated, after 38 completed weeks
  • Infants of diabetic mothers have a 2-4 fold increased risk of SD compared with infants of the same birth weight born to non diabetic mothers.
  • IOL does not prevent SD in non-diabetic women with a suspected macrosomic fetus.(Recommendation Level D)
  • IOL at term can reduce the incidence of SD in women with GDM.(Recommendation Level B)

References

  • Baskott TF,AllenAC.Perinatal implications of SD.Obstet Gynecol 1995;86:14-7
  • SmithRB,LaneC,PearsonJF.SD:what happens at the next delivery?Br J Obs Gynae 1994;101:713-15
  • AskerDB,SachsBP,FriedmanEA.Risk Factors for SD.Obs Gynae 1985;66:762-8
  • NesbittTS,GilbertWM,HerrchenB.SD and assoc RFs with macrosomic infants born in California.Am J O&G 1998:179:476-80
  • BaherAM.RFs and fetal outcome in cases of SD compared with normal deliveries of a similar birthweight.Br J Obst Gynae 1996:103:868-72
  • Centre for Reviews and Dissemination,NHS National Institute for Health Research.Expectant Mx vs IOL for suspected fetal macrosomia:a systematic review.Database of Abstracts of reviews of effectiveness 2004:2:2
  • IrionO,BoulvainM.IOL for suspected fetal macrosomia.Cochrane Database Systematic Rev 2002:2:CD 000938
  • UstaIM,HayekS,YahyaF,Abu-MusaA.SD:what is the risk of recurrence?Acta Obst Gynae Scand 2008:87:992-7