Assessment of maternal and perinatal outcome in cases of prolonged pregnancy in a tertiary healthcare institute: a cross sectional observational study

Background: Prolonged pregnancy has always been regarded as a high‑risk condition because perinatal morbidity and mortality is known to rise. The interest in postdatism (just beyond expected date of delivery) has been recent and the management is controversial, more so with the advent of sonography providing information about placental aging and amount of amniotic fluid.  The aim of the present retrospective study was to analyze the outcome of pregnancies which crossed the expected date of delivery.Methods: The present study was a cross sectional observational study, conducted between April 2018 to September 2018, among 90 cases presented with post dated pregnancy under the department of obstetrics and gynecology, in a tertiary medical teaching institute in Maharashtra.Results: Maximum number of cases, i.e., 22.22% indications were meconium stained liquor with fetal distress, in 18.51% cases indications were failure of induction, in 22.22% indications were nonreactive NST, in 17.61% cases indications were CPD.Conclusions: It was concluded that prolonged pregnancy was associated with significant risk of perinatal complications such as fetal distress, meconium aspiration syndrome and IUGR.

Fetomaternal outcome in post dated pregnancy

Background: The risks to the fetus increase after 41 weeks mainly due to increasing fetal weight, decline in placental function, oligohydramnios which increase chances of cord compression, and meconium aspiration. Perinatal mortality after 42 weeks is twice as compared to the perinatal mortality at 40 weeks and by 44 weeks the rate is increased up to threefold. In cases of prolonged pregnancy, fetus is more at risk of hypoxia during labor than a fetus at term.Methods: This cross sectional observational study of feto-maternal outcome in post dated pregnancy (Women beyond 40 weeks of gestation) was carried out in the department of obstetrics and gynaecology in a rural based tertiary care centre from October 2016 to September 2018, willing to participate and fulfilling the inclusion and exclusion criteria in the study period.Results: Majority i.e. 45 patients (46.9%) went into spontaneous labour and delivered vaginally, whereas 16 patients (16.7%) required caesarean section. Among all 45 participants who were given induction, maximum 26 (57.78%) were induced by Dinoprostone gel, 4 patients (8.89%) were induced by Tab. Misoprostol.Conclusions: The present study, we conclude that, the post dated pregnancy can be considered as a high risk factor from the point of view of fetal outcome as there is more fetal morbidity.

A Study on Obstetric Outcome of Postdated Pregnancy among Private Hospital Patients in Sylhet

Introduction: Any pregnancy which has passed beyondexpected date of delivery (EDD) is called postdated pregnancyor prolonged pregnancy.Objective: Main goal of this study is to evaluate obstetricoutcome in postdated pregnancy.Method: This was a prospective observational type study.Patients whose pregnancy extended beyond 40 weeks ofgestational age, patients who were sure of the date of lastmenstrual period (LMP) along with 1st trimester obstetrics scanwere included for this study. Patients not sure of LMP wereexcluded in this study. The study was conducted in theDepartment of Obstetrics and Gynecology, of different privatehospital Sylhet for study duration of 3 years. Total 223 caseswere selected purposively for this study.Results: The study result shows fetus condition among the223 pregnant women highest 96.41% were alive and only3.59% were dead. Male baby and female baby was almostsame male 49.33% and female baby 50.67%. After deliverybaby admitted in hospital 76.23%, NICU 6.28% not admitted17.49%. Most of the pregnant women’s (88.34%) managementwas oligo induction failure and rest was laparoscopy. Peroperative finding of the patients shows highest 74.89% pretermpre-mature rapture of membrane, 18.83% Ectopic pregnancyand 6.28% rapture uterus.Conclusion: Postdated pregnancy having 50% risk ofrecurrence in next pregnancy. It is a high risk pregnancy thefoetal complication in the form of foetal distress, meconiumaspiration syndrome, birth trauma etc. It also increases rate ofinstrumental delivery and operative delivery.

A Clinical Study of Post-dated Pregnancy among Government and Private Hospital Patients in Patuakhali

Introduction: Any pregnancy that has passed past expecteddate of delivery (EDD) is called post-dated pregnancy orprolonged pregnancy.Objective: The main objective of this study is to appraiseobstetric outcome for post-dated pregnancy in Patuakhali.Method: This was a potential observational type study.Patients whose pregnancy protracted beyond 40 weeks ofgestational age, patients who were certain of the date of lastmenstrual period (LMP) along with 1st trimester obstetrics scanwere included for this study. Patients not sure of LMP wereexcluded in this study. The study was conducted in thedepartment of obstetrics and gynaecology, of different privatehospital Patuakhali for study duration of 2 years. Total 150cases were selected purposively for this study.Results: Age segmentation of patients where the age ofpregnant women ranged from 16 to 30 years. Among the 150pregnant women highest 64% were in the age of 26-30 years.Delivery method amongst the 150 pregnant women are highestat 86% were caesarean delivery followed by normal deliveryonly 14%. Parity distribution among the 150 pregnant womenhighest 57.33% were Primigravida followed by Multigravida41.34% and 2nd pregnant were only 1.33%. Babies’ conditionamongst the 150 pregnant women, highest 96.30% foetuswere alive upon delivery and only 3.70% of the foetus weredead. In the gender distribution of the foetus, 49.33% wereborn as male and 50.67% were female. After delivery, thebabies that were admitted in hospital were 76.40%, in NICU6.40%, and not admitted in the hospital after delivery were at17.20% and 88.40% of the pregnant women’s managementresulted in oligo induction failure and the rest 11.60% wereconducted upon laparoscopy. Per operative findings of theselected patients show that the highest 74.40% were pretermpre-mature rupture of membrane, 18.80% were ectopicpregnancy and 6.80% had ruptured uterus.Conclusion: Post-dated pregnancy having almost 50% risk ofrecurrence in next pregnancy. It is a high-risk pregnancy thefoetal complication in the form of foetal distress, meconiumaspiration syndrome, birth trauma etc. It also raises rate ofinstrumental delivery and operative delivery.