[Evaluation of neonatal health in prolonged pregnancy in Shabih-Khani Hospital, Kashan, 2003]

ABSTRACT

Prolonged pregnancy influences different aspects of maternal and neonatal health. Although it is generally accepted that drug intervention is necessary before labor in prolonged pregnancy, there is still debate about the termination time of the pregnancy. Regarding the high prevalence of prolonged pregnancy we studied the neonatal health in the hospitalized women with prolonged pregnancy in kashan, in 2002-2003. This descriptive study was carried out on 450 women at gestational age over 40 weeks [based on their LMP or sonography before 30 weeks] admitted for termination of pregnancy by induction. The cases had no obstetrical problems. Neonatal health including type of delivery and dystocia, fetal distress, meconium, apgar in 5 minutes, NICU [neonatal intensive care unit] stay and weight were recorded and the cases were categorized into 4 groups based on gestational age 40 weeks to 40weeks and 3days, 40weeks and 4days to 41weeks, 41weeks and 1days to 41weeks and 3days and 41weeks and 4days and more. The results were analyzed by descriptive statistics chi-square, Kruskal-Wallis, and Mann-Whitney. The results showed that studied women terminated their pregnancy as follows 131 individuals [29.1%] terminated their pregnancy during 40 to 40weeks and 3 days, 150[33.3%] during 41 weeks and 1 day to 41 weeks and 3 days, and only 39 women [8.7%] terminated their pregnancy after 41weeks and 3days, 12 [2.7%] of whom were over 42 weeks. There was no significant difference between women in fetal stress, meconium, apgar in 5 minutes, NICU stay, neonatal weight, type of delivery and dystocia. However, the studied groups differed significantly in terms of cesarean cause based on pregnancy. Statistical tests showed that the studied groups in terms of mother's age [P=0.4], the history of prolonged pregnancy [p=0.08], number of parities [p=0.7], dilatation [p=0.2], cervix effacement based on pregnancy age had no significant difference. Based on the study results, termination of pregnancy prior to 41.5 weeks of gestational age due to fear of neonatal outcome is not necessary. Pre- term intervention can cause enhancement of cesarean. Thus, pregnancy termination could be delayed in pregnant women who are under control and have no compilcations