ABSTRACT
The timing of induction in the case of gestational diabetes mellitus (GDM) must meet two requirements: must be performed at a time that the fetus reaches lung maturity and before fetal growth reaches a point that increases the risk of shoulder dystocia. The published studies on the mode of delivery in GDM indicate a common denominator: an increase in the frequency of cesarean sections. In the same studies, this rate is very high, ranging in some series from 45% to 80%. Timing of delivery remains relatively open. There are no data to support delivery prior to term or cesarean delivery purely on the basis of GDM. Timing of delivery was not determined in the Austrian guidelines for gestational diabetes management. It is also known that obesity is associated with an increased risk of failed labor induction that appears to be related directly to an increasing class of obesity.
