LATE TERM AND POSTTERM PREGNANCIES: STILL AN OBTETRICIAN’S DILEMMA
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Background: Late term and postterm pregnancies include those pregnancies which fails to deliver beyond 40 weeks of gestation,and are associated with significant maternal and fetal morbidity and mortality.
Objective: The present study aims at finding out the incidence,maternal and fetal outcome associated with late term and posterm pregnancies.
Methodology: This prospective cross sectional study was conducted at Gynaecology and Obstetric Department of Mardan Medical complex,Mardan from February 2017 to July 2017.All pregnant women of any age,parity or booking status who sure of dates of their last menstrual period and had their first trimester ultrasound done,and had crossed their expected date of delivery were included in the study.Patients were recruited from antenatal OPD and Labor room.Data was entered in a predesigned proforma and analyzed through SPSS 20.0.
Results: Incidence of pregnancies beyond 40 weeks was found as 2.5%.The most prevalent age group was 20- 25 years,comprising 48(57%)patients.Forty eight(69%) women were primigravidas and 42(50%) had their period of gestation between 41 and 42 weeks.Induction of labor done in 51(60.75%),cesarean was done in 25(29.7%) whereas 8(9.5%) were in spontaneous labor.Most common indication for induction was oligohydramnios and gestational age more than 41 weeks in 23(45%) each whereas commonest indication was cesarean was fetal distress in 7(31%) and failed induction in 6(24%).birth asphyxia and meconium aspiration syndrome were commonest neonatal complications seen in 13(15%) for both.
Conclusion: Incidence of prolonged pregnancies can be reduced by creating awareness regarding regular antenatal visits,and importance of first trimester ultrasound and knowledge of last menstrual period dates.