DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20203299

Postdated pregnancy: its maternal and fetal outcome

Neetu Singh, Devyani Misra, Shubhi Srivastava

Abstract


Background: Postdated pregnancy is one of the commonest obstetric conditions. Pregnancy is called term when it lies between 37 weeks to 42 weeks from the last menstrual period. If the pregnancy exceeds 40 weeks it is called as postdated pregnancy. The overall incidence of post term pregnancy is 7% of all pregnancies.

Methods: This observational study was carried out in the department of obstetrics and gynecology in Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India from September 2019 to February 2020. Total 100 postdated pregnancy enrolled in the study those willing to participate and fulfilling the inclusion and exclusion criteria. Aim is to assess maternal and fetal outcome in postdated pregnancy.

Results: In present study, incidence of postdated pregnancy was found to be 5% and number of normal deliveries was 66 (66%), LSCS were 32 (32%) and 2 (2%) were instrumental delivery. Maternal complications were seen in 14 (14%) cases and fetal complications were found in 23 (23%) cases.

Conclusions: Postdated pregnancy was associated with perinatal complications like fetal distress, meconium aspiration syndrome and fetal asphyxia. There was increased risk of obstetrics complications like postpartum haemorrhage (PPH), perineal tear, cervical tear and shoulder dystocia. Management of postdated pregnancy is a challenge to obstetrician and a careful advice and monitoring can alleviate maternal anxiety and untoward complications.


Keywords


Last menstrual period, Maternal complication, Postdated, Pregnancy outcome

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References


Balakrishnan S. Textbook of Obstetrics. Hydrabad, India: Paras Medical Publishers; 2013: 218.

Neff MJ. ACOG releases guidelines on management of post-term pregnancy. Am Fam Physician. 2004;70:2221-5.

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.

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.

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

Van Eyk N, Allen LM, Sermer M, Davis VJ. Obstetric outcome of adolescent pregnancies. J Pediatr Adolescent Gynecol. 2000;13(2):96.

Mandruzzato G, Alfirevic Z, Chervenak F, Gruenebaum A, Heimstad R, Heinonen S. Guidelines for the management of postterm pregnancy. J Perinat. Med.2010:38(2010)111-9.

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

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 postdate pregnancy. Int J Sci Res. 2017;6(9):2015-8.

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

Alfirevic Z, Walkinshaw SA. Management of post-term pregnancy: to induce or not? Br J Hosp Med. 1994;52:218-21.

Mogren I, Stenlund H, Hogberg U. Recurrence of prolonged pregnancy. Int J Epidemiol. 1999;28:253-7

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.

Kabbur PM, Herson VC, Zaremba S, Lerer T. Have the year 2000 neonatal resuscitation program guidelines changed the delivery room management or outcome of meconium-stained infants? J Perinatol. 2005;25:694-7.

Spellacy WN, Miller S, Winegar A, Peterson PQ. Macrosomia - maternal characteristics and infant complications. Obstet Gynecol. 1985;66:158-61.

Rosen MG, Dickinson JC. Management of post-term pregnancy. N Engl J Med. 1992;326.

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.

Caughey AB, Washington AE, Laros RK. Neonatal complications of term pregnancies: rates increase in a continuous, not threshold fashion. Am J Obstet Gynecol. 2005;192(1):185-9

Caughey AB, Musci TJ. Complications of term pregnancies beyond 37 weeks of gestation. Obstet Gynecol. 2004;103:57-62.