A 27-year-old G1P0 with pregestational Type 1 diabetes has excellent control in the third trimester (HbA1c 6.0 percent), no vascular complications, normal fetal growth, and reassuring surveillance. If she has no other indication for earlier birth, the recommended timing of delivery is:

• A Elective induction at 37 weeks
• B Elective induction at 38 weeks
• C Expectant management until spontaneous labour
• D Elective induction at 39 weeks ✓

Explanation

For well controlled pregestational diabetes without vascular disease or poor glycemic control, delivery is planned at 39 weeks of gestation to balance stillbirth risk against neonatal respiratory morbidity. Earlier delivery around 37 to 38 weeks is considered for poor control, vascular complications, nephropathy, or deteriorating biophysical parameters. Expectant management beyond 40 weeks is avoided because the risk of intrauterine death rises in diabetic pregnancies.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.