الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
the timing of delivery in the diabetic pregnancy continues to be a controversial issue and is determined by obstetric and medical considerations.several studies have demonstrated that induction of labor in pregnancies complicated by diabetes at 37 weeks to 38 weeks not only did not increase the cesarean delivery rat , but also significantly decreased the incidence of fetal complications namely macrosomia and unexplained late fetal demise.
The timing of delivery in the diabetic pregnancy continues to be a controversial issue and is determined by obstetric and medical considerations. Several studies have demonstrated that induction of labor in pregnancies complicated by diabetes at 37 weeks to 38 weeks not only did not increase the cesarean delivery rate, but also significantly decreased the incidence of fetal complications namely macrosomia and unexplained late fetal demise. Induction of labour may be indicated despite an unripe cervix. Misoprostol is an effective method of induction of delivery with a low Bishop Score. But there is a lack of sufficient data regarding the optimal regime and safety as incorrect dosing may lead to unacceptable high incidence of complications.
Fifty pregnant diabetics at 37-38 weeks’ gestation fulfilling the selection criteria were recruited for this study. All cases were subjected to detailed history, Complete clinical, and obstetrical evaluation. Glycosylated haemoglobin and detailed obstetric ultrasound were also carried out for all cases. Ten cases fulfilling the selection criteria were subjected to elective caesarean section as controls. Forty cases proceeded according to the degree of cervical ripening (Bishop score). Cases with low Bishop score (unripe cervix), labour was induced using misoprostol vaginally until active phase of labour was reached, followed by oxytocin infusion if needed. Cases with favourable Bishop score (ripe cervix) will directly receive oxytocin drip infusion preceded by amniotomy. Termination by caesarean section was done in cases of failed cervical ripening, failed progress of labour or any manifestation of fetal or maternal distress.