Fetal sonographic characteristics associated with shoulder dystocia in pregnancies of women with type 1 diabetes

Abstract

Excessive estimated fetal weight and abdominal circumference at 36 weeks' sonographic examination may help in identifying diabetic women at high risk of later shoulder dystocia.

Pregnancy Outcomes in Women With Diabetes—Lessons Learned From Clinical Research: The 2015 Norbert Freinkel Award Lecture

“…Fetuses of women with diabetes often present with disproportionate overgrowth as indicated by increased abdominal circumference in relation to the head circumference. In practice, the largest circumference is often the area across the shoulders (50). Fetal overgrowth is therefore associated with increased risk of complications during labor, such as delayed progression of labor and shoulder dystocia (50).…”

“…In practice, the largest circumference is often the area across the shoulders (50). Fetal overgrowth is therefore associated with increased risk of complications during labor, such as delayed progression of labor and shoulder dystocia (50). In many countries, the prevalence of planned and acute caesarean sections among women with pregestational diabetes is therefore high.…”

“…One-quarter of these infants need life resuscitation at birth, and some of these infants suffer from injuries of bones and nerves (50).…”

Anthropometric differences in the newborns with brachial plexus palsy, clavicle fracture in pregnancies without risk factor

“…[13][14][15] However, some anthropometric studies on the newborns show that there may be some differences in the newborns undergoing shoulder dystocia. [16][17][18][19][20] Our aim in this study is to present newborn characteristics in complications such as BPP and clavicle, shoulder and humerus fractures with or without shoulder dystocia in our clinic and to make high suspicion and prediction for a potential shoulder dystocia and its complications. In order to achieve this purpose, we aimed to study with a group which was cleared of shoulder dystocia and its potential complications during pregnancy period as much as possible.…”

Recurrent shoulder dystocia: is it predictable?

“…There are several identifiable risk factors for shoulder dystocia, which can be divided to maternal, obstetrical, and fetal. Fetal risk factors include fetal macrosomia and perhaps fetal fat distribution [10][11][12]. Obstetrical risk factors include prolonged labor and instrumental delivery [13], and maternal risk factors are obesity and gestational diabetes mellitus (GDM) [14,15].…”