ABSTRACT
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.
ABSTRACT
Background: Late-term pregnancy defined as one that has reached between 41 0/7 weeks and 41 6/7 weeks of gestation is associated with an increased maternal morbidity as well as an increased risk of fetal and neonatal mortality and morbidity. Mifepristone, an anti-glucocorticoid and antiprogesterone, though not an oxytocic increases uterine activity and causes cervical effacement and dilatation and improves the Bishop score without over/hyper stimulation of uterus. Increased maternal and fetal mortality from late term pregnancy could be prevented by induction of labour. The objective of this study was to know the efficacy of single dose of oral mifepristone in induction of labour in late term pregnancy and to assess the induction delivery interval in the study population.Methods: This was a prospective interventional study conducted in Department of Obstetrics and Gynaecology at BGS Global Institute of Medical Sciences, Bengaluru. 100 Women with late term pregnancy who fulfilled the inclusion and exclusion criteria were considered for the study after an informed written consent.Results: 73.5% (n=36) of multigravida and 80.4% (n=41) of prim gravida showed improvement in the Bishop score post induction with mifepristone and majority (89.79 % primigravida and 84.31% multigravida) of the study population had vaginal delivery. Multigravida (73.5%) had less induction delivery interval (less than 48hours) compared to primigravida (19.6%).Conclusions: Mifepristone, a progesterone antagonist causes a significant improvement in the Bishop’s score and is associated with an increased rate of vaginal deliveries.
ABSTRACT
Objective To explore the risk factors for cesarean section after induction of late-term pregnancy. Methods This study enrolled 275 primiparas with a single cephalic fetal presentation,admitted to our hospital between December 2010 and December 2016 for induction of late-term pregnancy. After induction,80 underwent cesarean section and 195 had a normal vaginal delivery. Clinical data were collected and analyzed retrospectively. Single factor analysis and two categories of logistic regression analysis were used to determine the independent risk factors for cesarean section after induction of late-term pregnancy. Results Single factor analysis showed that the differences between the two groups in maternal height,cervical Bishop score before induction of labor,latent phase,intrapartum amniotomy,intrapartum oxytocin,meconium stained amniotic fluid,and birth weight were statistically significant (P < 0. 05). Multivariate analysis showed that maternal height,cervical Bishop score before induction of labor,and latent phase were independent risk factors for cesarean section after induction of late-term pregnancy. Conclusion Late-term pregnant primiparas with short stature,low Bishop score,or a long latent phase should have comprehensive prenatal maternal-fetal assessment,and a reasonable delivery mode should be chosen to avoid adverse outcomes.