FETOMATERNAL OUTCOME OF PREGNANCY BETWEEN 40 AND 42 WEEKS

Abstract

.Objective:To evaluatewhether serial monitoring of fetuses beyond 40 weeks with biophysical profileand non stress test improves the fetal outcome in terms of morbidity and mortality.Design: Prospective control study.Setting: Department of Obstetrics & Gynaecology at Ittefaq Hospital( Trust) Lahore,. Period: From Jan, 2007 to June2008.Patients and Methods: Two hundred women with singleton uncomplicated pregnancies at 40 weeks were dividedinto two groups; A study group with biweekly biophysical profile and non stress test and a control group with biweeklyantenatal clinical assessment with fetal kick count chart. Main outcome measures were onset of labour, mode ofdelivery, Apgar score, presence of meconium and admission to nursery. Results: The age of patients ranged between18 to 39 years with the mean of 26.33.The range of gravidity was between primigravida to gravida seven. Ninety sixpercent of total patients were delivered by 41 weeks and 6 days.18% of women were induced in study group comparedto 11% in control group ( p value=0.124 ).Cesarean section rate was 8% in study group and 11% in control group. Rateof instrumental deliveries was 6.5% in study group while 11.2% in control group. The difference in mode of delivery wasfound to be insignificant ( p=0.538 ).Weights of the babies ranged between 2.6 to 4.4 kg with a mean of 3.246 kg.Cumulative %age of APGAR score at 5 minutes was more than 6/10 in 92.5% cases ( p=0.665 ).Meconiumwas foundin 18% of cases in study group and 22% of control group( p=0.917 ).12 % of the babies were admitted to nursery instudy group compared to 16% in control group. Perinatal mortality was found to be 10/1000 in control group while therewas no perinatal death in study group. Conclusions: The difference of outcome between two groups was found to bestatistically insignificant which concluded the validity of either mode of management.