Continuous intrapartum fetal monitoring in gestational diabetes, where is the evidence?

Gestational Diabetes Mellitus (GDM) is one of the commonest complications in the pregnancy. It differs in pathogenesis and complications from pre gestational diabetes (PGD), yet the choices of birth and management options for women in labor do not differ between both entities. We have performed literature search to find any evidence behind these recommendations specifically to the subset of pregnant women who have developed diet-controlled GDM, with normal fetal growth. There have been no randomized control trials behind these recommendations. The aforementioned women have comparable outcomes to pregnant women who are not affected by diabetes and can be considered as low risk till any evidence is found. So there is an urgent need to conduct randomized controlled trials on women with well-controlled GDM and normal fetal growth scans so that these women could be provided evidence-based information on their options of birth.