scholarly journals “FETOMATERNAL OUTCOME IN POSTDATED PREGNANCY”

2021 ◽  
pp. 1-2
Author(s):  
Priti Singh ◽  
Krishna Sinha

Post term pregnancy has a highrisk for fetus. It often results in labour abnormalities like labor dystocia, fetal macrosomia and increased in chances of caesarean delivery. Management of pregnancy beyond 40 weeks gestation relies on an accurate assessment of the gestational age. In our study prolonged pregnancy was associated with significant risk of perinatal complications like fetal distress, meconium aspiration syndrome and IUGR. There was significantly increased risk of obstetric complications like oligohydramnios, perineal tear, atonic pph and shoulder dystocia.

Author(s):  
Vandana Verma ◽  
Vaibhav Kanti ◽  
Pragya Shree

Background: The term delivery is defined as that occurring between 259 and 294 days of pregnancy from the last menstrual period. If the pregnancy exceeds this period, it is called as post term pregnancy. Our center is in rural area where most of the patients are unbooked or even booked patients are also loss of follow up. So, this study was done to know the incidence of prolonged pregnancy and maternal and fetal outcome in case of prolonged pregnancy in our rural population.Methods: This study was a retrospective observational study for 1 year, to analyze the maternal and fetal outcome of post term pregnancies. Data was collected from hospital record and analysed.Results: Out of 5210 total deliveries 1.49 % were beyond 42 wks. 57.69 % patients delivered vaginally whereas 42.3 % patients needed cesarean section.  6.41 % neonates developed meconium aspiration syndrome and 15.38 % of neonates needed NICU admission for different indications.Conclusions: This study concluded that prolonged pregnancy is associated with adverse outcomes like fetal distress, meconium aspiration syndrome and more neonatal ICU admissions. The outcome of prolonged pregnancy can be improved by proper counselling for follow up during pregnancy and proper monitoring and appropriate management during labour.


Author(s):  
Neetu Singh ◽  
Devyani Misra ◽  
Shubhi Srivastava

Background: Postdated pregnancy is one of the commonest obstetric conditions. Pregnancy is called term when it lies between 37 weeks to 42 weeks from the last menstrual period. If the pregnancy exceeds 40 weeks it is called as postdated pregnancy. The overall incidence of post term pregnancy is 7% of all pregnancies.Methods: This observational study was carried out in the department of obstetrics and gynecology in Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India from September 2019 to February 2020. Total 100 postdated pregnancy enrolled in the study those willing to participate and fulfilling the inclusion and exclusion criteria. Aim is to assess maternal and fetal outcome in postdated pregnancy.Results: In present study, incidence of postdated pregnancy was found to be 5% and number of normal deliveries was 66 (66%), LSCS were 32 (32%) and 2 (2%) were instrumental delivery. Maternal complications were seen in 14 (14%) cases and fetal complications were found in 23 (23%) cases.Conclusions: Postdated pregnancy was associated with perinatal complications like fetal distress, meconium aspiration syndrome and fetal asphyxia. There was increased risk of obstetrics complications like postpartum haemorrhage (PPH), perineal tear, cervical tear and shoulder dystocia. Management of postdated pregnancy is a challenge to obstetrician and a careful advice and monitoring can alleviate maternal anxiety and untoward complications.


Author(s):  
Jitendra Pundlik Ghumare ◽  
Ganesh Mahadeo Bargaje

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.


Author(s):  
Ritika Narayan ◽  
Sheela S. R.

Background: Post-dated pregnancy is when the gestation is more than 40 weeks or 280 days. They last longer than the estimated date of delivery. Postdated pregnancies are associated with increased perinatal and maternal complications. These risks are greater than it was originally thought. Risks have been underestimated in the past leading to increasing number of complicated postdated pregnancies which appears to be otherwise low risk. The maternal risks are very often underappreciated resulting in increased maternal morbidity.Methods: This cross sectional observational study was done to evaluate maternal and fetal complications associated with Postdated pregnancies was carried out in the department of obstetrics and gynecology in a tertiary care centre, Sir Devraj Urs Medical College and RL Jalappa Hospital, Kolar between July 2018 and July 2019, fulfilling all the inclusion and exclusion criteria.Results: 50 out of 100 patients had full term normal deliveries where as 45% patients required cesarean section. Most common indication for cesarean section was meconium stained liquor with fetal distress (25%). 42% of the babies born needed NICU admission. Most common maternal complication seen was Postpartum Hemorrhage.Conclusions: The present study we conclude that postdated pregnancy was associated with significant risk of perinatal complications such as fetal distress, meconium aspiration syndrome and IUGR. There was increased risk of obstetric complications as well like atonic PPH, oligohydramnios, obstructed labor.


2022 ◽  
Vol 5 (1) ◽  
pp. 26-30
Author(s):  
N.J. Ermatov ◽  
T.A. Bobomuratov ◽  
M.A. Sagdullaeva

The article is devoted to the current problems of obstetrics, perinatology and neonatology. The article presents a literary review and covers scientific views on the factors of births and hazardous factors that lead to transfer and prolonged pregnancy. The most common perinatal complications of a delayed pregnancy are stillbirth, asphyxia, and birth trauma. Neonatal morbidity in premature infants is 29% and perinatal mortality is 19%, which is higher than in preterm infants. If the pregnancy is 43 weeks or more, these rates will increase. All of these diseases are associated with a decrease in the fetal resistance to hypoxia due to the large size of the brain and morphological changes in the placenta. Therefore, the incidence of meconium aspiration syndrome and fetal distress syndrome at birth increases, leading to high perinatal morbidity and mortality.


Author(s):  
Aarthi Rajendran ◽  
Rajni Parikh

Background: Postdated pregnancy is gestation longer than 40 weeks or 280 day. Prolonged pregnancy is defined as any pregnancy that last 294 days or more. Reported frequency of post term pregnancy range from 3 - 1 4 percent with an average of about 10 percent. Several studies have concluded that these pregnancies are accompanied by a rise in perinatal morbidity and mortality. The presumed etiology for this rise is placental insufficiency. Abnormalities such as congenital anomalies, oligohydramnios, meconium aspiration, fetal asphyxia, fetal dysmaturity, macrosomia and shoulder dystocia are commonly observed in these pregnancies Materials and Methods: This study was conducted in the Department of Obstetrics and Gynecology, after approval from the Ethics Committee, from January 2019 to September2020 on 150 patients in the department of Obstetrics and Gynaecology, willing to participate and fulfilling the inclusion and excliusion criteria in the study period. Results: Of the total 150 women, 122 (81.34%) were in 40 weeks group; 28 (18.66%) in 41 weeks group and 0 (0%) were in > 42 weeks group. Most women (89.3%) were between 20-35 years of age. Among 150 women, 40 (26.6%) went into spontaneous labor, 87(8.0%) were induced andn23 (15.34%) was taken for caesarian section. Misoprostol, Dinoprostone gel and oxytocin were the different modes of induction (Table 7). Misoprostol was used in the majority of inductions followed by Dinoprostone gel. The success rate between these two is almost similar (92.45% & 95.1%).Lscs rate was 15.33%.Most of the newborn had weight between 2.5-3.5kg in 68.25% of women in gestational age >40 weeks. Conclusions: The present study, we conclude that postdated pregnancy can be considered as a high risk factor from the point of fetal outcome as there is more fetal morbidity. Keywords: High risk pregnancies, maternal mortality, Outcomes, Perinatal mortality, postdated pregnancy.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Elaine M. Finucane ◽  
Linda Biesty ◽  
Deirdre Murphy ◽  
Amanda Cotter ◽  
Eleanor Molloy ◽  
...  

Abstract Background Post-term pregnancy is associated with an increased risk of maternal complications, respiratory distress and trauma to the neonate. Amniotic membrane sweeping has been recommended as a simple procedure to promote the spontaneous onset of labour. However, despite its widespread use, there is an absence of evidence on (a) its effectiveness and (b) its optimal timing and frequency. The primary aim of the MILO Study is to inform the optimal design of a future definitive randomised trial to evaluate the effectiveness (including optimal timing and frequency) of membrane sweeping to prevent post-term pregnancy. We will also assess the acceptability and feasibility of the proposed trial interventions to clinicians and women (through focus group interviews). Methods/design Multicentre, pragmatic, parallel-group, pilot randomised controlled trial with an embedded factorial design. Pregnant women with a live, singleton foetus ≥ 38 weeks gestation; cephalic presentation; longitudinal lie; intact membranes; English speaking and ≥ 18 years of age will be randomised in a 2:1 ratio to membrane sweep versus no membrane sweep. Women allocated randomly to a sweep will then be randomised further (factorial component) to early (from 39 weeks) versus late (from 40 weeks) sweep commencement and a single versus weekly sweep. The proposed feasibility study consists of four work packages, i.e. (1) a multicentre, pilot randomised trial; (2) a health economic analysis; (3) a qualitative study; and (4) a study within the host trial (a SWAT). Outcomes to be collected include recruitment and retention rates, compliance with protocol, randomisation and allocation processes, attrition rates and cost-effectiveness. Focus groups will be held with women and clinicians to explore the acceptability and feasibility of the proposed intervention, study procedures and perceived barriers and enablers to recruitment. Discussion The primary aim of the MILO Study is to inform the optimal design of a future definitive randomised trial to evaluate the effectiveness (including optimal timing and frequency) of membrane sweeping to prevent post-term pregnancy. Results will inform whether and how the design of the definitive trial as originally envisaged should be delivered or adapted. Trial registration ClinicalTrials.gov NCT04307199. Registered on 12 March 2020


Author(s):  
Defairlin Ranee ◽  
Deepa S. Phirke

Background: Meconium staining of amniotic fluid (MSAF) is a relatively common problem occuring in 10-25% of all deliveries. Meconium aspiration syndrome is more common in term babies than in preterm babies with rising frequency along with increase in gestational age of the fetus. Meconium stained amniotic fluid generally indicates sign of fetal distress. The objective of this study was to study clinical profile of meconium aspiration syndrome and the probable risk factors for meconium aspiration syndrome.Methods: It is a prospective observational sectional study conducted in NICU of department of paediatrics of tertiary care centre from 1st January 2015 to 30th June 2016.Results: In this study both sexes were equally affected, majority of the neonates were above 2.5kg and only very few (2 neonates) were less than 1.5kg. majority of the neonates were full term, it was found that there is a significant association between thick MSAF and the development of MAS, it was found that there is a significant association between low APGAR score at 1 minutes and the development of MAS, there is a strong association between thick MSAF and mortality in MSAF babies. Anemia 38 (25%) was the most frequent perinatal risk factor followed by fetal distress 27 (18) and PIH 21 (14%).Conclusions: Newborns with thick MSAF were more likely to develop MAS and thick MSAF and low APGAR at 1 min were associated with high risk of development of MAS. Passage of thick meconium was significantly associated with severe birth asphyxia and carried a bad prognosis with increased risk of development of meconium aspiration syndrome and hypoxic ischaemic encephalopathy.


2017 ◽  
Vol 66 (2) ◽  
pp. 93-103
Author(s):  
Ainura M Burkitova ◽  
Viktoriya S Prokhorova ◽  
Viacheslav M Bolotskikh

This review is devoted to etiology and diagnostics post-term and prolonged pregnancy. We analyzed the results of studies aimed at the study of diagnostic, pregnancy and complications in childbirth in pregnant women at high risk for post-term pregnancy. When evaluating methods of prenatal training in prolonged and post-term pregnancy most studies showed greatest efficacy in the preparation of the cervix, and the lowest frequency of complications in childbirth when using antigestagens in comparison with other methods of preparing the cervix for childbirth. Despite the long history of the study of this problem, many questions concerning post-term pregnancy, are not fully studied and actual to this day.


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