Conversely, planned cesarean delivery may be a reasonable strategy for diabetic women with an estimated fetal weight >4250 or >4500 g. Conway and Langer (1998) described a protocol of routine cesarean delivery for sonographic estimates of �4250 g in diabetic women. This management significantly lowered the shoulder dystocia rate from 2.4 to 1.1 percent.
In summaly, we agree with the College that elective delivery for the fetus that is suspected to be overgrown is inadvisable, particularly before 39 weeks' gestation. Finally, we also conclude that elective cesarean delivery is not indicated when estimated fetal weight is <5000 g among women without diabetes and < 4500 g among women with diabetes (American College of Obstetricians and Gynecologists, 2016a, 2017b).
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