Study of maternal and fetal outcome in pregnancy beyond 40 weeks: a prospective observational study at a tertiary institute
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20203993Keywords:
Late term pregnancy, Post term pregnancy, Fetomaternal complications, Induction of labour, Caesarean sectionAbstract
Background: Prolonged pregnancy is one that exceeds 42 0/7weeks. Management of prolonged pregnancy is very challenging in modern obstetrics.
Methods: It is prospective observational study in department of Obstetrics and Gynecology, Shri B.M Patil medical college and Research center, deemed to be University, Vijayapur, North karnataka. Study period was from January 2018 to January 2019.
Results: Total of 186 pregnant women were included in the study. Results in terms of age, gravidity, gestational age, time of induction, mode of delivery, neonatal outcome and maternal complications.
Conclusion: Pregnancies beyond 40 weeks require early detection, effective fetal monitoring and proper planning of labour. In pregnancies beyond 40 weeks, decision of induction should be taken cautiously as early induction leads to failure of induction and increased rates of lower (uterine) segment Caesarean section (LSCS), while delayed induction leads to increased fetal complications.
References
Definition of term pregnancy. Committee Opinion No. 579. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2013;122:1139-40.
Mya KS, Laopaiboon M, Vogel JP, Cecatti JG, Souza JP, Gulmezoglu AM et al. Management of pregnancy at and beyond 41 completed weeks of gestation in low-risk women: a secondary analysis of two WHO multi-country surveys on maternal and newborn health. Reprod Health. 2017;14(1):141.
Norwitz ER, Snegovskikh VV, Caughey AB. Prolonged pregnancy: when should we intervene? Clin Obstet Gynecol. 2007;50:547-57.
Oberg AS, Frisell T, Svensson AC, Iliadou AN. Maternal and fetal genetic contributions to post term birth: familial clustering in a population-based sample of 475,429 Swedish births. Am J Epidemiol. 2013;177:531-7.
Elden H, Hagberg H, Wessberg A, Sengpiel V, Herbst A, Bullarbo M et al. Study protocol of SWEPIS a Swedish multicentre register based randomised controlled trial to compare induction of labour at 41 completed gestational weeks versus expectant management and induction at 42 completed gestational weeks. BMC Pregnancy Childbirth. 2016;16:49.
Galal M, Symonds I, Murray H, Petraglia F, Smith R. Post term pregnancy. Facts Views Vis Obgyn. 2012;4(3):175-87.
Australian Institute of Health and Welfare 2019. National Core Maternity Indicators. Cat. no. PER 95. Canberra: AIHW. Available at: https://www.aihw. gov.au/reports/mothers-babies/ncmi-data-visualisations. Accessed on 13 August 2020.
Gahwagi MMM, Benali F, Bettamer NM, Zubi AS. To Determine the Effects of Labor Induction on Maternal and Fetal Outcome in Postterm Pregnancies (41 Weeks Plus). Int J Clin Medi. 2017;8:98-110.
Spong CY. Defining “term” pregnancy: recommendations from the Defining “Term” Pregnancy Workgroup. JAMA. 2013;309:2445-6.
WHO. World Health Organization recommendations for induction of Labour 2011. http://apps.who.int//iris/handle/10665/44531. Accessed 11 August 2020.
Roos N, Sahlin L, Ekman-Ordeberg G, Kieler H, Stephansson O. Maternal risk factors for postterm pregnancy and cesarean delivery following labor induction. Acta Obstet Gynecol Scand. 2010;89(8):1003-10.
Vayssière C, Haumonte JB, Chantry A, Coatleven F, Debord MP, Gomez C et al. Prolonged and post-term pregnancies: guidelines for clinical practice from the French College of Gynecologists and Obstetricians (CNGOF). Eur J Obstet Gynecol Reprod Biol. 2013;169(1):10-6.
Gupta M, Shrivastava S, Rai S. To study the maternal and fetal outcome in pregnancy beyond 40 weeks. Int J Clin Obstet Gynaecol. 2020;4(2):123-9.
Kandalgaonkar VP, Kose V. Fetomaternal outcome in postdated pregnancy. Int J Reprod Contracept Obstet Gynecol. 2019;8:1899-906.
Shinge N, MM VK, Prashanth S. Comparative studyof maternal and fetal outcome in pregnancies of gestational age 40 completed weeks and beyond. J Evol Med Dent Sci. 2013;2(25):4509-16.
Dakshnamurthy P, Jagannathan S, Sharma N, Rajendran K. A study of maternal and fetal outcome in postdated pregnancy. Int. J Allied Med Sci Clin Res. 2017;5(2):600-6.
Punya BS. Study of post-dated and term pregnancy with fetomaternal outcome at RRMCH. Indian J ObstetGynaecol Res. 2017;4(2):179-83.
Kaimal AJ, Little SE, Odibo AO, Stamilio DM, Grobman WA, Long EF et al. Cost effectiveness of elective induction of labor at 41 weeks in nulliparous women. Am J Obstet Gynecol. 2011;204(2):137:1-9.
Coates D, Makris A, Catling C, Henry A, Scarf V, Watts N et al. A systematic scoping review of clinical indications for induction of labour. PLoS ONE. 2020;15(1):e0228196.
Burgos J, Rodríguez L, Otero B, Cobos P, Osuna C, del Mar Centeno M et al. Induction at 41 weeks increases the risk of caesarean section in a hospital with a low rate of caesarean sections. J Matern Fetal Neonatal Med. 2012;25(9):1716-8.
Fok WY, Chan LY, Tsui MH, Leung TN, Lau TK, Chung JTK. When to induce labor for post-term? A study of induction at 41 weeks versus 42 weeks. Eur J Obstet Gynecol Reprod Biol. 2006;125(2):206-10.
Middleton P, Shepherd E, Morris J, Crowther CA, Gomersall JC. Induction of labour at or beyond 37 weeks' gestation. Cochrane Database Syst Rev. 2020;7(7):CD004945.
WHO recommendations: Intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018.
