A study of maternal and fetal outcome in pregnancy beyond 40 weeks of gestation

Abstract

Background: Pregnancy beyond dates is one of the most frequent clinical dilemma faced by the obstetricians. It is controversial whether to choose expectant management with antepartum foetal surveillance or to induce labour. Materials and Methods: This Prospective cross sectional study included 200 pregnant women both primigravida and multigravida beyond 40 weeks of gestation admitted in Dept. of OBG, Al-Ameen Medical College, Vijayapur, India from December 2018 to May 2020. A detailed history and examination was carried out along with close observation till delivery and postnatal period. Patients who did not enter into labour spontaneously after 40 weeks of gestation were offered induction of labour. Data was documented and analysed. Results: Out of 200 patients studied, 124 were multigravida and 76 were primigravida’s which was significant. 166 cases were in the gestational age group of 40 wk – 40 wk 6 days and only 8 cases were beyond 42 weeks of gestation. 73.5 % of the cases delivered vaginally, the rate of caesarean section was 26.5 %. Severe oligohydramnios was the most common indication for caesarean section. The rate of induction was 13%. The overall rate of NICU admission was 12.5%. Conclusion: The rate of caesarean section and perinatal morbidity increased as the gestational age increased in our study. According to the present study it seems reasonable to induce labour at 40 weeks of gestation to have a favourable outcome.