DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20191940

Fetomaternal outcome in post dated pregnancy

Vishakha Prakash Kandalgaonkar, Varsha Kose

Abstract


Background: The risks to the fetus increase after 41 weeks mainly due to increasing fetal weight, decline in placental function, oligohydramnios which increase chances of cord compression, and meconium aspiration. Perinatal mortality after 42 weeks is twice as compared to the perinatal mortality at 40 weeks and by 44 weeks the rate is increased up to threefold. In cases of prolonged pregnancy, fetus is more at risk of hypoxia during labor than a fetus at term.

Methods: This cross sectional observational study of feto-maternal outcome in post dated pregnancy (Women beyond 40 weeks of gestation) was carried out in the department of obstetrics and gynaecology in a rural based tertiary care centre from October 2016 to September 2018, willing to participate and fulfilling the inclusion and exclusion criteria in the study period.

Results: Majority i.e. 45 patients (46.9%) went into spontaneous labour and delivered vaginally, whereas 16 patients (16.7%) required caesarean section. Among all 45 participants who were given induction, maximum 26 (57.78%) were induced by Dinoprostone gel, 4 patients (8.89%) were induced by Tab. Misoprostol.

Conclusions: The present study, we conclude that, the post dated pregnancy can be considered as a high risk factor from the point of view of fetal outcome as there is more fetal morbidity.


Keywords


High risk pregnancies, Maternal mortality, Outcomes, Perinatal mortality, Postdated pregnancy

Full Text:

PDF

References


World Health Organization. ICD-10: international statistical classification of diseases and related health problems: tenth revision, 2nd ed. World Health Organization, 2004. Available at: http://www.who.int/iris/handle/10665/42980.

Spong CY. Defining term pregnancy: recommendations from the Defining Term‖ Pregnancy Workgroup. JAMA. 2013;309(23):2445-6.

Reddy UM, Bettegowda VR, Dias T, Yamada-Kushnir T, Ko CW, Willinger M. Term pregnancy: a period of heterogeneous risk for infant mortality. Obstet Gynecol. 2011;117(6):1279.

Tita ATN, Landon MB, Spong CY, Lai Y, Leveno KJ, Varner MW, et al. Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med. 2009;360(2):111-20.

Taipale P, Hiilesmaa V. Predicting delivery date by ultrasound and last menstrual period in early gestation. Obstet Gynecol. 2001;97(2):189-94.

Savitz DA, Terry JW, Dole N, Thorp JM, Siega-Riz AM, Herring AH. Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination. Am J Obstet Gynecol. 2002;187(6):1660-6.

Divon MY, Ferber A, Nisell H, Westgren M. Male gender predisposes to prolongation of pregnancy. Am J Obstet Gynecol. 2002;187(4):1081-3.

Usha Kiran TS, Hemmadi SBJ. Outcome of pregnancy in a woman with an increased body mass index. BJOG. 2005;112(6):768-72.

Heimstad R, Romundstad PR, Salvesen KÅ. Induction of labour for post‐term pregnancy and risk estimates for intrauterine and perinatal death. Acta Obstet Gynecol Scand. 2008;87(2):247-9.

Caughey AB, Washington AE, Laros RK. Neonatal complications of term pregnancy: rates by gestational age increase in a continuous, not threshold, fashion. Am J Obstet Gynecol. 2005;192(1):185-90.

Caughey AB, Stotland NE, Washington AE, Escobar GJ. Maternal and obstetric complications of pregnancy are associated with increasing gestational age at term. Am J Obstet Gynecol. 2007;196(2):155-e1.

Usher RH, Boyd ME, McLean FH, Kramer MS. Assessment of fetal risk in postdate pregnancies. Am J Obstet Gynecol. 1988;158(2):259-64.

Paliulytė V, Ramašauskaitė D. Labour induction in postdate pregnancy: when to start-at week 40 or 41 of gestation? Acta Medica Litu. 2010;17.

Mahapatro A, Samal S. Fetomaternal outcome in pregnancy beyond 40 week. Int J Pharma Bio Sci. 2015;6(2):53-8.

Akhter P, Sultana M, Hoque M, Sultata S, Khatun MR, Dabee SR. Maternal outcome of prolonged pregnancy. J Bangladesh Coll Phys Surg. 2014;32(2):66.

Dobariya PV, Shah PT, Ganatra HK. Feto-maternal outcome in pregnancy beyond 40 weeks. Int J Reprod Contracept Obstet Gynecol. 2017;6(2):527-31.

Patel N, Modi P. A Study of maternal and fetal outcome in post date pregnancy. 2017;6(9):2015-8.

Francis S. A retrospective study on fetomaternal outcome beyond 40 weeks period of gestation. Indian J Res. 2015:4(12):113-5.

Naz F, Javid A, Saeed S. Neonatal outcome in post-term pregnancy. Age (Omaha). 2006;42(45):75.

Oberg AS, Frisell T, Svensson AC, Iliadou AN. Maternal and fetal genetic contributions to postterm Birth: Familial clustering in a population-based sample of 475,429 Swedish Births. Am J Epidemiol. 2013;177(6):531-7.

Caughey AB, Nicholson JM, Cheng YW, Lyell DJ, Washington AE. Induction of labor and cesarean delivery by gestational age. Am J Obstet Gynecol. 2006;195(3):700-5.

Shinge N, MM VK, Prashanth S. Comparative study of maternal and fetal outcome in pregnancies of gestational age 40 completed weeks and beyond. J Evol Med Dent Sci. 2013;2(25):4509-16.

Szpera-Goździewicz A, Goździewicz T, Rajewski M, Skrzypczak J, Bręborowicz Gh. Management in pregnancy after 41 weeks of gestation. Archives of Perinatal Medicine. 2013. 19(2), 101-106.

Akhter S. Maternal and perinatal outcome in postdated pregnancy: a study of 100 cases in Bangladesh armed forces. J Armed Forces Med Coll Bangladesh. 2014:10(1):39-44.

Thakur R, Kelkar YV, Shrivastava N. Perinatal risk in postdated pregnancy. Presented in 29th AICOG 1985.