Prolonged pregnancy

2020 ◽  
pp. 389-394
Author(s):  
Kate F. Walker ◽  
Jim G. Thornton
Keyword(s):  
Caesarean Section ◽  
Pregnancy Loss ◽  
Expectant Management ◽  
Induction Of Labour ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Increased Risk ◽  
Oxytocin Infusion ◽  
Prolonged Pregnancy ◽  
Overall Risk

Prolongation of gestation beyond 42+0 weeks (or 294 days) affects about 6% of pregnancies. It is associated with an increased risk of perinatal morbidity and mortality; the overall risk of pregnancy loss (stillbirth plus death occurring up to the age of 1 year) increases eightfold between 37 weeks and 43 weeks. Since trials comparing induction of labour with expectant management suggest that induction does not increase the rate of caesarean section, many clinicians offer it for pregnancies beyond 41 weeks. Induction of labour is usually performed using prostaglandin ripening followed, if necessary, by amniotomy and oxytocin infusion.

scholarly journals Frequency of Caesarean Section in Pregnancies with Borderline Amniotic Fluid Index at Term

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Natasha Bushra ◽  
Khaula Zeeshan ◽  
Sara Ejaz ◽  
Javeria Mushtaq ◽  
Khadija Waheed ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Induction Of Labour ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Increased Risk ◽  
Failed Induction ◽  
One Year

AbstractThe increased risk of caesarean section after induced labour is well documented. Rate of induction of labour has doubled in the past decade from 10 to 20%. Low Amniotic Fluid Index (AFI) as an isolated finding leads to increased obstetrical interventions but without any improvement in outcome.Objectives:  To determine the frequency of caesarean section due to failed induction in pregnancies at term with borderline AFI.Patients and Methods:  This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Unit-III, SIMS/Services Hospital, Lahore. The duration of study was one year from January, 2015 to December, 2015. A total of 150 patients were included in this study. AFI was measured by recent obstetric ultrasound. All patients with borderline AFI (5 – 8 cm) were included in the study. They were induced by glandin E2 gel. If induction of patients failed with two doses of glandin E2 gel, given vaginally 6 hours apart, patients were considered for cesarean section. The outcome measure was rate of caesarean section due to failed induction. All data were analyzed by SPSS version 20.Results:  Mean age of the patients was 30.34 ± 6.68 years. Mean gestational age was noted 38.34 ± 1.05 weeks. Out of 150 patients, 103 (68.7%) were para 1 – 3 and 47 patients (31.3%) were para 4 – 6. Caesarean section due to failed induction with borderline AFI was performed in 27 patients (18.0%). Stratification with regard to age, gestational age and parity was carried out and was found significant only for gestational age being > 39 weeks.Conclusion:  It is concluded that failed induction of labour at term in women with borderline AFI is not associated with increased risk of caesarean delivery.

scholarly journals An analytical study of intraoperative, immediate post-operative and perinatal complications in previous two caesarean section

2018 ◽  
Vol 7 (10) ◽  
pp. 4239
Author(s):  
Prachi Singh ◽  
Ritika Agarwal ◽  
Shweta Yadav
Keyword(s):  
Caesarean Section ◽  
Analytical Study ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Perinatal Complications ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Adherent Placenta ◽  
Maternal Morbidity And Mortality

Background: Lower segment caesarean section is one of the commonest operations performed now a day.It has been seen that in cases with previous caesarean section there is increased maternal morbidity and mortality due to placenta previa, adherent placenta and caesarean hysterectomy.The present study was conducted to know the fetomaternal outcome and intra and immediate post-operative complications in cases with previous two lower segment caesarean section.Methods: The present study was conducted in TMMC Moradabad between January 2017-January 2018.Total 68 cases were previous two lower segment caesarean section were included in the study. Neonatal outcome and intraoperative and immediate postoperative complications were seen in these cases.Results: In the present study majority of the cases were in 30-34 years age group (39.7%), the maximum number of caesarean sections were done between gestational age of 37-39.6 weeks (47.1%). Intraoperatively adhesions between uterus, anterior abdominal wall and bladder was seen in less than half of the cases i.e. in 42.6% cases. Out of 68 cases with previous two lower segment caesarean operated 13 cases had placenta previa and 4 cases had adherent placenta.Conclusions: The present study shows that the maternal and perinatal morbidity and mortality is increased with increasing number of caesarean sections. So, there should be reduction in rate of primary caesarean section which can reduce the rate of placenta previa and adherent placenta in subsequent pregnancies.

scholarly journals Analysis of caesarean section practices and consequences in Goma, DR Congo: Frequency, indications, maternal and perinatal morbidity and mortality

2019 ◽  
pp. 091-098
Author(s):  
Michel Dikete Ekanga ◽  
Mitangala Prudence ◽  
Coppieters Yves ◽  
Kirkpatrick Christine ◽  
Kabuseya Richard ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Dr Congo

scholarly journals A comparative study of feto-maternal outcome in expectant management versus active management in pre-labor rupture of membranes at term

2017 ◽  
Vol 7 (1) ◽  
pp. 146
Author(s):  
Savitha T. S. ◽  
Pruthvi S. ◽  
Sudha C. P. ◽  
Vikram S. Nadig
Keyword(s):  
Caesarean Section ◽  
Maternal Morbidity ◽  
Caesarean Section Rate ◽  
Mode Of Delivery ◽  
Expectant Management ◽  
Neonatal Morbidity ◽  
Neonatal Infection ◽  
Induction Of Labour ◽  
Active Management ◽  
Induction Group

Background: Premature rupture of the membranes at term is spontaneous rupture of the membranes after 37 weeks of gestation and before the onset of the regular painful uterine contractions, complicates 5-10% of pregnancies, 80% of cases of PROM occur at term. It complicates the pregnancy leading to maternal and fetal complications, immediate risks such as cord prolapse, cord compression and placental abruptions, and later risks such as maternal or neonatal infection and the interventions such as caesarean section and instrumental vaginal delivery. These cases are either managed conservatively or by immediate induction of labour. Objective of present study is to compare the efficacy and safety of induction of labor versus expectant management at term PROM, in terms of maternal and fetal outcome.Methods: A randomized control trial of 100 women coming to KIMSH from 01 /04 /2015 to 01 /05 /2016 with PROM at term with duration of leak ≤6 hours and a Bishop score ≤5 were assigned to group A immediate induction group and group B expectant management group with 50 cases in each group.Results: The mean interval from PROM to delivery was significantly shorter in the induction Group 15.62±4.97 as compared with expectant group 17.58±4.78. Incidence of maternal morbidity and neonatal morbidity was comparable in both the groups. Intrapartum complications and mode of delivery were similar in both groups.Conclusions: Immediate induction of labour in cases of PROM at term using oral misoprostol resulted in shorter induction delivery interval and hospital stay. Maternal morbidity and neonatal morbidity was comparable in both groups. It is concluded that immediate induction is better than expectant management. With active management many patients delivered vaginally within 24 hours without increase in the Caesarean section rate and decreased the need for oxytocin augmentation.

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