Fetomaternal outcome beyond 40 weeks period of gestation

Introduction: The timely onset of labor and birth is an Important Determinant of perinatal outcome. Pregnancy beyond due date is one of the most frequent clinical dilemma faced by the obstetricians, whether to choose expected management with ante partum fetal surveillance or to prescribe induction of labor remains controversial. So, the present study is conducted to analyse fetomaternal outcome beyond the expected date of delivery.
Material and Methods: The prospective clinical study was conducted in the Department of Obstetrics and Gynaecology J.N.M.C.H, A.M.U. during 2016-2018.Total of 250 antenatal women beyond 40 weeks of gestation were included in the study after fulfilling the inclusion and exclusion criteria. After Institutional Ethics Committee approval all recruited women were divided into 3 groups. Group I – Women with 40-40weeks 6days period of gestation. Group II – Women with 41-41 weeks 6days period of gestation. Group III- Women with 42 weeks period of gestation.
Results: Out of 250 pregnant women , 181(72.4%) women were in 40-40weeks 6days , 56(22.4%)women were in 41-41 weeks 6days and 13(5.2%) women belongs to 42 weeks period of gestation. Most of the cases were primigravida 136(54.4%)with Mean±S.D maternal age of 24.92±3.28 years & mean gestational age of 40+40wks 6days Out of 402 cases 201 (50%) underwent spontaneous labor & 201( 50 %) needed induction of labor. Most common mode of delivery was vaginal constituting 177(70.8%. Meconium stained liqor was present in 36(14.4%) of women. Fetal distress with meconium stained liqour were the common indication for caesarean section. 14 (5.6% ) babies were admitted to NICU most of the admissions 6(33.33%) were for meconium aspiration syndrome. Intrauterine fetal demise occurred in 5 cases(27.78%) without any risk factors. Pregnancy beyond 40wks increases the chance of oligohydramnios , Caesarean section for fetal distress and NICU admission for meconium aspiration syndrome.
Conclusion: Elective induction of labor with an unfavourable cervix should be discouraged and waiting till 41weeks with proper feto-maternal surveillance and then inducing improves maternal and neonatal outcome.