A 31-year-old G2P1 with diet-controlled gestational diabetes has been achieving all glucose targets since diagnosis at 26 weeks. There are no other maternal or fetal complications. At 38 weeks she requests induction. What is the most appropriate plan according to current guidance?
- A Expectant management until around 40 to 41 weeks with routine antenatal surveillance ✓
- B Induce labour now at 38 weeks
- C Elective caesarean at 39 weeks
- D Induction at 34 weeks to prevent shoulder dystocia
Correct answer: A. Expectant management until around 40 to 41 weeks with routine antenatal surveillance
Explanation
For well-controlled, diet-treated GDM without complications, guidance such as NICE supports awaiting spontaneous labour up to 40 to 41 weeks, since induction earlier offers no perinatal advantage. Elective birth between 37 and 38+6 weeks is reserved for women on pharmacological therapy. Shoulder dystocia risk in this setting does not justify delivery at 34 weeks, which would create iatrogenic prematurity.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.