DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20184132

Comparison of fetal outcome in spontaneous versus induced labor in postdated pregnancy: a study in a tertiary care centre

Nikhil Anand, Hardik Shah

Abstract


Background: Pregnancy lasting beyond 40 weeks is a known complication of normal delivery. Various studies have found incidence between 2-14%. Post-dated pregnancy carries specific hazards to both mother and fetus. While mothers are faced with problems like increased incidences of induced labour, instrumental delivery and LSCS with associated morbidities, fetuses are faced with morbidities ranging from IUGR to macrosomia. Authors tried to study fetal outcome in post-dated pregnancy present study. The objective is to compare fetal outcome in spontaneous versus induced labour in post-dated pregnancy.

Methods: This is a prospective cross-sectional study done at a tertiary care hospital in obstetrics and gynecology in duration of 18 months. After screening according to inclusion criteria, all patients who were admitted in labour wards are selected and two groups were created according to clinical examination. First group consists of patients with spontaneous onset of labour and second group consists of patients with induction of labour. In each group USG, NST and BPP were performed, and labor monitored according to standard partograph. Fetal outcomes in both groups were studied.

Results: Fetal outcomes were nearly same in both groups, induced and spontaneous onset of labour, except a few like thick meconium which was common in spontaneous onset group while rate of LSCS was more in induced group.

Conclusions: Women with uncomplicated pregnancies should be offered induction of labour, while women with any complicating factors LSCS should be considered.


Keywords


Induction, LSCS, Neonatal morbidity, Postdatism

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References


WHO: recommended definitions, terminology and format for statistical tables related to the perinatal period and use of a new certificate for cause of perinatal deaths. Modifications recommended by FIGO as amended October 14, 1976. Acta Obstet Gynecol Scand. 1977;56(3):247-53.

FIGO. Report of The FIGO Subcommittee On Perinatal Epidemiology And Health Statistics. London: FIGO; 1986.

Olesen AW, Westergaard JG, Olsen J. Perinatal and maternal complications related to post term delivery: a national register-based study, 1978-1993. Am J Obstet Gynecol. 2003;189:222-7.

Norwitz ER, Snegovskikh VV, Caughey AB. Prolonged pregnancy: when should we intervene?. Clin Obstet Gynecol. 2007;50:547-57.

Manning FA, Platt LD, Sips L, Keegan KA. Fetal breathing movements and non stress test in high risk pregnancies. Am J obstet Gynaecol. 1979;135:511-5.

Vorherr H. Placental insufficiency in relation to postterm pregnancy and fetal postmaturity: Evaluation of fetoplacental function; management of the postterm gravida. Am J Obstetr Gynecol. 1975;123(1):67-103.

Grant JM. Induction of labour confers benefits in prolonged pregnancy. Br J Obstet Gynaecol. 1994;101:99-102.

Divon MY, Haglund B, Nisell H, Otterblad PO. Fetal and neonatal mortality in postterm pregnancy: the impact of gestational age and fetal growth restriction. Am J Obstet Gynecol. 1998;178(4):726-31.

Ahanya SN, Lakshmanan J, Morgan BL, Ross MG. Meconium passage in utero: mechanisms, consequences, and management. Obstet Gynecol Survey. 2005;60(1):45-56.

Starks GC. Correlation of meconium stained amniotic fluid, early intrapartum fetal pH and Apgar scores as predictors of perinatal outcome. Obstet Gynecol. 1980;56(5):604-9.

Krebs HB, Peters RE, Dunn LJ. Intrapartum fetal heart rate monitoring. Association of meconium with abnormal fetal heart rate patterns. Am J Obstet Gynecol. 1980;137:936-43.

Weiner Z, Farmakides G, Schulman H, Casale A, Iskovitz-Eldor J. Central and peripheral haemodynamic changes in post term fetuses: correlation with oligohydramnios and abnormal fetal heart rate pattern. Br J Obstet Gynaecol. 1996;103(6):541-6.

Pandis GK, Papageorghiou AT, Ramanathan VG, Thompson MO, Nicolaides KH. Pre-induction sonographic measurement of cervical length in the prediction of successful induction of labor. Ultrasound Obstet Gynecol. 2001;18(6):623-8.

Pattison N, McCowqn L. Cardiotocography for antepartum fetal assessment. The Cochrane Database Syst Rev. 2000;2:CD001068.

Macer JA, Macer CL, Chan LS. Elective induction versus spontaneous labor: a retrospective study of complications and outcome. Am J Obstet Gynecol. 1992;166(6):1690-7.

David AM, Yolando A, Rabello, Richard HP. The MBPP: antepartum testing in 1990s. Am J Obstet Gynaecol. 1996;174:812-7.

Vintzileous AM, Campbell WA, Ingardie CJ, Nochimson DJ. The foetal BPP and it predictive value. Obstet Gynaecol. 1983;62:217-8.

Eden RD, Sifert LS, Kodack LD, et al. A MBPP for antenatal fetal surveillance. Obstet Gynecol. 1988;71(3):365-9.

Singal P, Anjana S, Deepali J, Vishal P. Fetomaternal outcome following postdate pregnancy-a prospective study. J Obstet Gynecol Ind. 2001;51(5):89-93.