Fetomaternal outcomes beyond 40 weeks of gestation: a retrospective study

Jayashalini S.; Ranoji Shinde

doi:10.18203/2320-1770.ijrcog20250203

Authors

Jayashalini S. Department of Obstetrics and Gynaecology, Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu, India
Ranoji Shinde Department of Obstetrics and Gynaecology, Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20250203

Keywords:

Late-term pregnancy, Post-term pregnancy, Maternal outcomes, Neonatal outcomes, Induction of labor, Retrospective study

Abstract

Background: Pregnancies extending beyond 40 weeks, categorized as late-term (40–41+6 weeks) or post-term (≥42 weeks), are associated with increased risks of adverse maternal and neonatal outcomes. This study aims to evaluate and compare fetomaternal outcomes in late-term and post-term pregnancies.

Methods: This retrospective observational study was conducted at the department of obstetrics and gynecology, Chettinad health and research institute. Medical records of 300 women aged 18-45 years, who delivered after 40 weeks of gestation between January 1, 2023, and December 31, 2023, were analyzed. Exclusion criteria included teenage pregnancies, elderly gravida (>45 years), past caesarean sections, and breech/transverse presentations. Data on demographic characteristics, induction methods, maternal and neonatal outcomes, and complications were collected and statistically analyzed using SPSS version 25.0.

Results: Out of 300 participants, 225 (75%) delivered at late-term, while 75 (25%) delivered post-term. Caesarean delivery rates were higher in post-term pregnancies (55%) compared to late-term (35%) (p<0.01). Maternal complications, including postpartum hemorrhage (PPH) (15%), perineal tears (10%), and uterine rupture (5%), were significantly more prevalent in post-term pregnancies (p<0.05). Neonatal complications were also higher in post-term deliveries, with increased rates of macrosomia (30% vs. 15%), NICU admissions (27% vs. 15%), and meconium-stained amniotic fluid (40% vs. 20%) (p<0.01). Stillbirths were exclusive to post-term pregnancies (7%).

Conclusions: Post-term pregnancies are associated with significantly higher maternal and neonatal risks compared to late-term pregnancies. Timely induction of labor and enhanced surveillance in pregnancies beyond 40 weeks are crucial to minimizing complications. These findings support the implementation of evidence-based management strategies to improve fetomaternal outcomes in prolonged pregnancies.

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