A comparative study of the maternal, fetal and early neonatal outcome at term and post-term gestation
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.
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