A study of maternal and fetal outcome in postdated pregnancy

Abstract

Objective

To assess the whether the elective induction of labor at 41 weeks is associated with lower caesarean section rates as compared to elective induction of labor at 40 weeks in a postdated pregnancy. Perinatal morbidity and mortality were also compared at 40 weeks and 41 weeks of gestation.

Participants

Labor was induced in 50 cases of postdated pregnant women at 41 weeks. 50 cases of post-dated women with labor induction at 40 weeks were taken as controls.

Main outcome measures

The primary outcome was assessed as the incidence of microsomal/low birth weight, color of liquor, incidence of MAS, NICU admission rate, APGAR score less than 7 at 5 minutes. Secondary outcome was incidence of instrumental delivery (vacuum, forceps) and LSCS.

Results

There was a minimal increase in the incidence of babies with increased birth weight (>3.6kg) in the study group (7% vs. 4%). The meconium staining of liquor is higher in the study group (65% vs. 35%). Though there was a higher rate of meconium staining of liquor and the need for amnioinfusion in the study group, the NICU admissions, Apgar of <7 at 5 minutes and the number of neonatal deaths were the same in both the groups. The LSCS rates are low (16% Vs 28%) in the study group. The rates of instrumental delivery (12%) in the study group is less compared to the control group (26%)

Conclusion

NICU admissions, APGAR score at 5 minutes and neonatal mortality is almost the same in both study and control group. Labor Induction at 41 weeks is more likely to culminate in a normal delivery as the Bishop score improves. Induction of labor in an uncomplicated low risk pregnancy at 41+ weeks of gestation is associated with reduced caesarean section rates with no adverse effect on neonatal outcome.