Delivery should be by the vaginal route unless there are obstetric contraindications.
If the labour is planned then breakfast and insulin should be omitted.
Management of blood glucose is by intravenous infusion:
All other infusions should not contain dextrose.
Foetal distress is more common in diabetic labours. Continuous CTG monitoring is required; when there is concern, foetal scalp blood should be analysed for pH and gases.
Shoulder dystocia is rare with good diabetic control. Any suspicion of cephalopelvic disproportion is an indication for caesarian section.
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