A 34 year old female in labor has gestational diabetes. What complication may arise?

When considering the scenario of a 34-year-old female in labor with gestational diabetes, one of the key complications that may arise is that the baby may be too large to deliver, which is referred to as macrosomia. Gestational diabetes can lead to higher levels of glucose in the mother’s bloodstream. This excess glucose crosses the placenta, stimulating the baby's pancreas to produce more insulin, which in turn promotes fat and muscle growth in the fetus. As a result, babies born to mothers with poorly controlled gestational diabetes are often larger than average, which can complicate delivery.

Large babies can lead to several delivery complications, such as shoulder dystocia, where the baby's shoulder gets stuck during delivery, and an increased likelihood of requiring a cesarean section due to the size of the baby making vaginal delivery more difficult. While other complications can be associated with gestational diabetes, such as a slightly increased risk of birth defects or prolonged labor, the most directly relevant and significant concern when it comes to labor is the potential for delivering a very large infant, impacting the delivery process itself.