Journal of Health Sciences & Research

Register      Login

VOLUME 12 , ISSUE 1 ( January-June, 2021 ) > List of Articles

RESEARCH ARTICLE

Maternofetal Outcome of Postdated Pregnancy: A Retrospective Analysis

Nikita Gandotra, Heena Gupta

Keywords : Maternal morbidity, Perinatal morbidity, Postdated

Citation Information : Gandotra N, Gupta H. Maternofetal Outcome of Postdated Pregnancy: A Retrospective Analysis. J Health Sci Res 2021; 12 (1):1-4.

DOI: 10.5005/jp-journals-10042-1098

License: CC BY-NC 4.0

Published Online: 21-07-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Pregnancy beyond dates is one of the most frequent clinical dilemmas faced by the obstetrician. Postdated pregnancy is a universally accepted indication for antenatal fetal monitoring because of the increased risk of antepartum fetal demise with advancing gestational age. Method: This study was a retrospective observational study for 1 year to analyze the maternal and fetal outcomes of postdated pregnancies. Data were collected from hospital records and analyzed. Results: In the present study, the incidence of postdated pregnancy was found to be 6.23; 0.46% were spontaneous vaginal deliveries, and 30% were induced deliveries. The lower segment cesarean section (LSCS) was done in 21% of patients and failed induction being the most common indication for LSCS. Maternal complications were seen in 12 (12%) cases, and fetal complications were found in 13 (13%) cases. Conclusion: Management protocol for postdated pregnancy is fetal surveillance for prolonged pregnancy, induction of labor, and proper monitoring of labor during intrapartum care.


PDF Share
  1. ACOG Committee Opinion No 579: definition of term pregnancy. Obstet Gynecol 2013;122:1139. DOI: 10.1097/01.aog.0000437385.88715.4a.
  2. Fernando A. Prolonged pregnancy. In: Nasim S (ed) Practical guide to high risk pregnancy and delivery. Noida: Elsevier; 2008, pp. 255–256.
  3. Eik-Nes SH, Okland O, Aure JC, et al. Ultrasound screening in pregnancy: a randomized controlled trial. Lancet 1984;567:1347. DOI: 10.1016/s0140-6736.
  4. Ingemarsson I, Hedén L. Cervical score and onset of spontaneous labor in prolonged pregnancy dated by second-trimester ultrasonic scan. Obstet Gynecol. 1989 Jul;74(1):102-5. PMID: 2660039.
  5. Olesen AW, Westergaard JG, Olsen J. Perinatal and maternal complications related to post term delivery: a national register-based study, 1978-1993. Am J Obstet Gynecol 2003;189:222–227. DOI: 10.1067/mob.2003.446.
  6. Caughey AB, Stotland NE, Washington AE. Maternal obstetric complications of pregnancy are associated with increasing gestational age at term. Am J Obstet Gynecol 2007;196:155.e1. DOI: 10.1016/j.ajog.2006.08.040.
  7. Divon MY, Haglund B, Nisell H, et al. Fetal and neonatal mortality in the post term pregnancy: the impact of gestational age and fetal growth restriction. Am J Obstet Gynecol 1998;178(4):726–731. DOI: 10.1016/s0002-9378(98)70482-x.
  8. Van Eyk N, Allen LM, Sermer M, et al. Obstetric outcome of adolescent pregnancies. J Pediatr Adolescent Gynecol 2000;13(2):96. DOI: 10.1016/s1083-3188(00)00033-4.
  9. Cunningham FG, Leveno KJ, Bloom SL, et al. Post-term pregnancy. In: William's obstetrics. 23rd ed. New York: McGraw-Hill Companies; 2010, pp. 832–841.
  10. Mandruzzato G, Alfirevic Z, Chervenak F, et al. Guidelines for the management of post term pregnancy. J Perinat Med 2010;38:111–119. DOI: 10.1515/jpm.2010.057.
  11. Feldman GB. Prospective risk of stillbirth. Obstet Gynecol. 1992 Apr;79(4):547-53. PMID: 1553174.
  12. Bakketeig LS, Bergsjo P. Post-term pregnancy: magnitude of the problem. In: Enkin M, Keirse MJ, Chalmers I (eds) Effective care in pregnancy and childbirth. Oxford: Oxford University Press, 1989.
  13. Nakling J, Backe B. Pregnancy risk increases from 41 weeks of gestation. Acta Obstet Gynecol Scand 2006; 85:663. DOI: 10.1080/00016340500543733.
  14. Divon MY, Haglund B, Nisell H, et al. Fetal and neonatal mortality in the post term pregnancy: the impact of gestational age and fetal growth restriction. Am J Obstet Gynecol 1998;178:726. DOI: 10.1016/s0002-9378(98)70482-x.
  15. De Los Santos-Garate AM, Villa-Guillen M, Villanueva-García D, et al. Perinatal morbidity and mortality in late-term and post-term pregnancy. NEOSANO perinatal network's experience in Mexico. J Perinatol 2011;31:789. DOI: 10.1038/jp.2011.43.
  16. Bruckner TA, Cheng YW, Caughey AB. Increased neonatal mortality among normal-weight births beyond 41 weeks of gestation in California. Am J Obstet Gynecol 2008;199:421.e1. DOI: 10.1016/j.ajog.2008.05.015.
  17. Heuser C, Manuck T, Hossain S, et al. Non-anomalous stillbirth by gestational age: trends differ based on method of epidemiologic calculation. J Matern Fetal Neonatal Med 2010; 23:720. DOI: 10.3109/14767050903387086.
  18. Hannah ME, Hannah WJ, Hellmann J, Hewson S, Milner R, Willan R and the Canadian Multicenter Post-term Pregnancy Trial Group (1992) Induction of labor as compared with serial antenatal monitoring in post-term pregnancy. A randomized controlled trial. New Eng J Med 326:1587–1592.
  19. Maiti K, Sultana Z, Aitken RJ, et al. Evidence that fetal death is associated with placental aging. Am J Obstet Gynecol 2017;217:441.e1. DOI: 10.1016/j.ajog.2017.06.015.
  20. Middleton P, Shepherd E, Morris J, et al. Induction of labour at or beyond 37 weeks’ gestation. Cochrane Database Syst Rev 2020;7:CD004945. DOI: 10.1002/14651858.CD004945.pub5.
  21. Guidetti DA, Divon MY, Langer O. Postdate fetal surveillance: is 41 weeks too early? Am J Obstet Gynecol 1989;161:91. DOI: 10.1016/0002-9378(89)90240-8.
  22. Bochner CJ, Williams J, Castro L, et al. The efficacy of starting postterm antenatal testing at 41 weeks as compared with 42 weeks of gestational age. Am J Obstet Gynecol 1988;159:550. DOI: 10.1016/s0002-9378(88)80005-x.
  23. Alfirevic Z, Walkinshaw SA. A randomised controlled trial of simple compared with complex antenatal fetal monitoring after 42 weeks of gestation. Br J Obstet Gynaecol 1995;102:638. DOI: 10.1111/j.1471-0528.1995.tb11402.x.
  24. American College of Obstetricians and Gynecologists. Practice bulletin no. 146: management of late-term and post term pregnancies. Obstet Gynecol 2014;124:390. DOI: 10.1097/01.AOG.0000452744.06088.48.
  25. Kistka ZA, Palomar L, Boslaugh SE, et al. Risk for post term delivery after previous post term delivery. Am J Obstet Gynecol 2007;196:241.e1. DOI: 10.1016/j.ajog.2006.10.873.
  26. Kortekaas JC, Kazemier BM, Ravelli AC, et al. Recurrence rate and outcome of post term pregnancy, a national cohort study. Eur J Obstet Gynecol Reprod Biol 2015;193:70. DOI: 10.1016/j.ejogrb.2015.05.021.
  27. Verma V, Kanti V, Shree P. Maternal and fetal outcome in post term pregnancy. Int J Reprod Contracept Obstet Gynecol 2017;6(7):2897–2899. DOI: 10.18203/2320-1770.ijrcog20172632.
  28. Kandalgaonkar VP, Kose V. Fetomaternal outcome in post dated pregnancy. Int J Reprod Contracept Obstet Gynecol 2019;8(5):1899–1906. DOI: 10.18203/2320-1770.ijrcog20191940.
  29. Singh N, Misra D, Srivastava S. Postdated pregnancy: its maternal and fetal outcome. Int J Reprod Contracept Obstet Gynecol 2020;9(8):3223–3227. DOI: 10.18203/2320-1770.ijrcog20203299.
  30. Akhter P, Sultana M, Hoque M, et al. Maternal outcome of prolonged pregnancy. J Bangladesh Coll Phys Surg 2014;32(2):66. DOI: 10.3329/jbcps.v32i2.26033.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.