Abstract
Objectives: To study the maternal and fetal outcome and complications in post-term pregnancies and to compare them with an equal number of term pregnancies. Materials and Methods: The study was conducted in the department of OBG, AIMS, B.G. Nagara. 50 cases of post-term singleton pregnancies with Gestational age > 42 weeks, 18-35 years of age with reliable dates and no obstetric or medical complications were the study group. The control group comprised of 50 singleton pregnancies between 37 and 42 weeks, 18-35 years of age with reliable dates and no obstetric or medical complications. The maternal morbidity was based on mode of delivery, operative interventions, injuries, PPH and Fetal morbidity was based on number of fetuses with meconium staining of amniotic fluid, NICU admissions, asphyxia, metabolic complications. Results: Post-term pregnancy was found to be associated with increased morbidity, In the mother, labor had to be induced in a significant number of cases (p 0.070) since a large number of them had a low Bishop's score (p=0.086). Operative interference in the form of LSCS was positively associated with post-term (p=0.166) with causes varying from the failure of induction, prolonged labor. fetal distress, macrosomia and oligohydramnios (p <004). Perinatal morbidity was significantly associated with Post-term (32.0% vs 6.06) with P<0.001 due to birth asphyxia, meconium aspiration syndrome, the incidence of Meconium stained liquor being 60% (P-0.001). Conclusion: The maternal and fetal morbidity is significantly increased after 42 weeks. There is a great need for accurate dating of pregnancy. The importance of induction of labor at 41 weeks and definitely not beyond 42 weeks cannot be sufficiently stressed.
Highlights
Post Term Pregnancy- Incidence of post-term pregnancy varies according to the definitions used and the population studied
4% - 7.3% of pregnancies extend beyond 43 weeks [5]. 20% to 40% of post-term pregnancies result in post maturity syndrome [6]
The signs of post maturity cannot be considered pathognomonic because they are absent in one-fifth to one-third of postterm neonates and may not infrequently be observed in infants born at term
Summary
Post Term Pregnancy- Incidence of post-term pregnancy varies according to the definitions used and the population studied. Oligohydramnios (defined as an amniotic fluid index < cms) is associated with potential perinatal complications or compromise [3] It develops in about 0.5% to 4% of these pregnancies depending on the population, the interval between testing and delivery and criteria for diminished amniotic fluid volume Prominent increases or decreases in amniotic fluid index of post-term patients had no associated adverse fetal outcome irrespective of the rate of change of the amniotic fluid index provided the final value remained > 5.0 cms. To study the maternal and fetal outcome and complications in post-term pregnancies and to compare them with an equal number of term pregnancies. To use the significant data to arrive at an appropriate scheme of management of post-term pregnancies thereby preventing complications
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