Most of this guideline is aimed at secondary care. From our point of view:
- Elective Caesarean may be offered to diabetic women with an estimate birth weight of over 4.5kg (though it is acknowledged that estimation of birth weight is inaccurate).
- Previous shoulder dystocia – ask for this at booking. If there has been shoulder dystocia in a previous pregnancy, there is up to 10x higher risk of it recurring. An elective caesarean shouldn’t be routinely recommended, but should be discussed with the woman as an option.