Diabetes – oxytocin less effective for these women

For years now diabetes has been known to complicate birth for many women and unfortunately the incidence of ‘type two diabetes’ is increasing as our weight as a nation increases.

According to researchers at the University of Liverpool approximately 60% of diabetic women (including those who develop diabetes during pregnancy) will be unable to complete labour naturally and will require a caesarean.

Until now the reason for this has not been fully understood. Researchers have found “that contractions in women who had the disease were not as strong as those in non-diabetic women…Calcium levels in the uterus should rise to allow the muscle to contract effectively. Researchers found, however, that in women with diabetes, calcium levels are significantly reduced. “ University press release

While the result itself is useful in understanding why this is happening to so many of the 35,000 women that have diabetes during pregnancy every year, the implications for the management of diabetic labours is perhaps even more significant.

Researchers found that when uterine tissue of diabetic women was treated with oxytocin (a drug often used to assist labours that are experiencing difficulties) it was found that contractions “failed to reach the same levels of contractility as in non-diabetic women.” While more research is on-going, this finding does suggest that advice to women as they plan their birth ought to consider caesarean birth as a prophylactic option and more specifically for those wishing to attempt labour that the door is left open to switching to a caesarean during labour earlier such that they can have a caesarean before real signs of distress result in ‘critical’ surgical intervention.

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