Analysis of maternal and foetal outcome of post-dated pregnancy in a tertiary care centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20240778Keywords:
Post term gestation, Fetal distress, Meconium stained liquor, Perinatal mortalityAbstract
Background: Managing pregnancy with post-dates is becoming a challenging issue due to increasing fetal morbidity and mortality. The study aimed to analyse the maternal and fetal outcomes of post-term pregnancies among Indian women, considering their earlier fetal maturation. Conducted over 18 months with 100 cases, the prospective observational study focused on pregnant mothers at or beyond 40 weeks gestational age, excluding those with certain medical complications.
Methods: After obtaining approval from the ethics committee and informed consent from eligible participants, detailed histories and examinations were conducted, with close monitoring until delivery and postnatal care. Inclusive criteria encompassed singleton pregnancies with cephalic presentation, while exclusions included non-cephalic presentation, congenital anomalies, and various medical complications.
Results: Revealed a predominance of primigravida women aged 20 to 35 years at 40 to 40 weeks and 6 days gestation. Spontaneous delivery occurred in 58%, with 90% delivering vaginally, while all multigravida births were vaginal post-induction. Cesarean sections were performed in 14%, primarily due to failed induction followed by fetal distress. Meconium-stained liquor was most prevalent at 42 weeks or later, correlating with higher perinatal mortality and NICU admissions in infants born beyond 42 weeks.
Conclusions: Vigilant monitoring proved crucial in averting fetal jeopardy, emphasizing the importance of timely interventions to mitigate complications associated with post-term pregnancies. This study sheds light on the unique considerations and outcomes of post-dated pregnancies in the Indian population, contributing valuable insights for maternal and neonatal care in similar settings.
References
Cunningham FG, Kenneth JL, Steven LB, John CH, Dwight JR, Catherine YS. Williams Obstetrics, 23rd ed. New York (USA): McGraw-Hill. 2010;832.
Galal M, Symonds I, Murray H, Petraglia F, Smith R. Postterm pregnancy. Facts Views vis ObGyn. 2012:4(3):175.
American College of Obstetricians and Gynecologists Diagnosis and Management of post term pregnancy. Washington. The College: Technical Bulletin No. 130. 1989.
Eden RD, Seifert LS, Winegar A, Spellacy WN. Perinatal characteristics of uncomplicated postdate pregnancies Obstet Gynecol. 1987;69(3 pt 1):296.
Hannah ME, Hannah WJ, Hellmann J, Hewson S, Milner R, Willan A, et al. Canadian Multicenter Post Term Pregnancy Trial Group. Induction of labor as compared with serial antenatal monitoring in post term pregnancy. N Engl J Med. 1992;326(24):1587.
Barss VA, Frigoletto FD, Diamond F. Still birth after non-stress testing. Obstet Gynecol. 1985;65(4):541-4.
Schifrin BS, Guntes V, Gergely RC, Eden R, Roll K, Jacobs J, et al The role of real-time scanning in antenatal fetal surveillance. Am J Obstet Gynecol. 1980;136(5):787.
Smith CV, Nguyen HN, Kovacs B, McCart D, Phelan JP, Paul RH, et al. Fetal death following antepartum fetal heart testing: A review of 65 cases. Obstet Gynecol. 1987;70(1):18-20.
Manning FA, Platt LD, Sipos LRN. Development of a fetal biophysical profile. Am J Obstet Gynecol. 1980;136(6):787.
Smith CV, Phelan JP, Paul RH, Broussard P. Fetal acoustic stimulation testing. A retrospective experience with the acoustic stimulation test. Am J Obstet Gynecol. 1985;153(5):567.
Weiner Z, Reichler A, Zlozover M, Mendelson A, Thaler I. The value of Doppler ultrasonography on prolonged pregnancies. Eur J Obstet Gynecol Reprod Biol. 1993;48(2):93-7.
Young R. The management of prolonged pregnancy. An analysis of women' s attitudes before and after term. Br J Obstet Gynecol. 1991;98(1):1102-6.
Harris BA Jr, Huddleston JF, Sutliff G, Perlis HW. The unfavourable cervix in prolonged pregnancy. Obstet Gynecol. 1983;62(2):171- 4.
American College of Obstetricians and gynecologists: Management of post term pregnancy. Practice pattern. No 6. 1997.
Singal P. Study fetomaternal outcome following post-date pregnancy. J Obst Gynecol India. 2001;51:89-93.
Sanchez-Ramos L, Felicia L, Delke I, Kaunitz AM. Labor induction versus expectant management for post term pregnancies: A systematic review with Meta analysis. Obstet Gynecol. 2003;101(6):1312-8.
Behra RC, Kandoth SK, Goyal BK. Labour induction in unfavourable cervix. J Obst Gyn India. 1997;47:335-43.
Hannah ME, Hannah WJ, Hellmann J, Hewson S, Milner R, Willan A. Canadian Multicenter Post Term Pregnancy Trial Group. Induction of labor as compared with serial antenatal monitoring in post term pregnancy. N Engl J Med. 1992;326(24):1587.
Alexander JM, McIntire DD, Leveno KJ. Forty weeks and beyond: Pregnancy outcomes by week of gestation. Obstet Gynecol. 2000;96(2):291-4.
