Published: 2019-08-26

A clinical study of maternal outcome in post dated pregnancy in a tertiary care hospital

Nikhil Anand, Hardik Shah


Background: Pregnancy lasting beyond 40 weeks is a known complication of normal delivery. 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. We here tried to study maternal outcome in post-dated pregnancy. The objective is to study maternal outcome in post-dated pregnancy and to compare maternal outcome in spontaneous versus induced labour in post-dated pregnancy.

Methods: This study was done at a tertiary care hospital in obstetrics and gynecology department for duration of 18 months. After screening according to inclusion criteria, all patients who were admitted in labour wards were grouped in two groups 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 same protocol for fetal monitoring were performed, and labor monitored according to standard partograph. Maternal outcomes in both groups were studied.

Results: Maternal outcomes were nearly same in both groups; induced and spontaneous onset of labour, except rate of LSCS, Which was more in induced group though not statistically significant.

Conclusions: Women with uncomplicated post dated pregnancies with good bishop score should be allowed spontaneous labour and those with poor bishop should be offered induction of labour, while women with any complicating factors LSCS should be considered.


Induction, LSCS, Maternal morbidity, Postdatism

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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.

Report of the FIGO subcommittee on perinatal epidemiology and health statistics following a workshop on the methodology of measurement and recording of infant growth in perinatal period. Cairo. November 11 to 18, 1984. International Federation of Gynecology and Obstetrics (FIGO). London. Int J Gynecol Obstet. 1986;24:483.

Olesen AW, Westergaard JG, Olsen J. Perinatal and maternal complications related to postterm delivery: a national register-based study, 1978-1993. Am J Obstet Gynecol. 2003;189:2227.

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

Eik-Nes SH, Okland O, Aure JC, Ulstein M. Ultrasound screening in pregnancy: A randomised controlled trial. Lancet. 1984;1:1347.

Ingemarsson I, Hedén L. Cervical score and onset of spontaneous labor in prolonged pregnancy dated by second-trimester ultrasonic scan. Obstet Gynecol. 1989;74:102-5.

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.

Marahatta R, Tuladhar H, Sharma S. Comparative study of post term and term pregnancy in Nepal Medical College Teaching Hospital (NMCTH). Nepal Med Coll J. 2009;11:57-60.

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

Vorherr H. Placental insuffiency in relation to postterm pregnancy and fetal postmaturity: Evaluation of fetoplacental function Management of post term gravida. Am J Obstet Gynecol. 1975;123:67.

Rand L, Robinson JN, Economy KE. Post-term induction of labor revisited. Obstet Gynecol. 2000;96(5 Pt 1):779-83.

Campbell MK, Ostbye T, Irgens LM. Post-term birth: risk factors and outcomes in a 10-year cohort of Norwegian births. J Obstet. Gynecol. 1997;89(4):543-8.

Alexander JM, McIntire DD, Leveno KJ. Forty weeks and beyond: pregnancy outcomes by week of gestation. Obstet Gynecol. 2000;96(2):291-4.

Treger M, Hallak M, Silberstein T. Post-term pregnancy: should induction of labor be considered before 42 weeks? J Maternal Fetal Neonatal Med. 2002;11(1):50-3.

Eden RD, Seifert LS, Winegar A. Perinatal characteristics of uncomplicated postdate pregnancies. Obstet Gynecol. 1987;69:296-9.

Alexander J, Macer CL, Chan LS. Elective induction versus spontaneous labour: A prospective study of complications and outcome. Am J Obstet Gynecol. 1992;166:1690-7.

Reddy UM, KO CW, Willinger M. Maternal age and risk of stillbirth throughout pregnancy in the United States. Am J Obstet Gynecol. 2006;195(3):764-70.

Singhal P, Sharma A, Jain S, Pandey V. Fetomaternal outcome following postdate pregnancy-a prospective study. J Obst Gynecol Ind. 2001;51(5):89-93.

Gulmezoglu AM, Crowther CA, Middleton P. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev. 2012;6:CD00494.