In cases of diabetes accompanying macrosomia, what is the likelihood of shoulder dystocia?

Shoulder dystocia is a significant concern in pregnancies complicated by diabetes, particularly when macrosomia (an excessive fetal size, often defined as a weight greater than 4,000 grams or 8 pounds 13 ounces) is present. In these scenarios, the likelihood of experiencing shoulder dystocia is notably higher due to the increased fetal size leading to a higher incidence of larger fetuses.

Research and clinical observations indicate that when diabetes is involved, especially with poorly controlled blood glucose levels, the risk of shoulder dystocia rises substantially. Estimates suggest that the incidence of shoulder dystocia in the context of diabetes and macrosomia ranges from 20% to 50%. This elevated risk is linked to the excess fetal growth caused by hyperglycemia, which affects fetal fat deposition and overall size, making it more challenging to navigate delivery.

Therefore, recognizing the correct likelihood of shoulder dystocia as being within the range of 20-50% emphasizes the need for careful management and monitoring in diabetic pregnancies to reduce potential complications during delivery.