Higher incidence of emergency caesarean section for delay in first stage of labour in diabetic compared to non-diabetic pregnant women. (18th April 2012) - Dawood, F
Abstract : Background: Diabetes in pregnancy accounts for a disproportionately high caesarean section (CS) rate. Pursuant to our previous in vitro laboratory findings of impaired uterine contractility in diabetics (DM), we hypothesised that more emergency C/S in DM are secondary to delay in the first stage of labour reflecting poor uterine function. Methodology: We conducted a case control retrospective study at Liverpool Womens' Hospital over a 10 -year period from January 2001 to January 2011. Of 73 560 deliveries, 1183 were diabetic (DM) pregnancies. We compared delivery outcomes with 1099 non-DM controls matched for age, parity and previous C/S. Results: The C/S rate was higher in DM compared to controls; the overall CS rate was 65% in type 1 DM (table 1 ). There was a higher number of C/S for failed induction and C/S due to delay in first stage in DM patients including DM with normal BMI (table 2 ). Conclusion: These results suggest that even accounting for differences in BMI, diabetic women had an increased rate of emergency C/S due to delay in the first stage of labour compared to non-DM, supporting the laboratory findings of deficient myometrial contractility.