Uncomplicated prolonged pregnancy management, complications and outcome .

Category:

Research type: Research Paper

Authors: Abdalla, Batool El Khider .

Abstract: This case control study was conducted in Omdurman Maternity Hospital in 6 months period, to evaluate the maternal and fetal outcome in uncomplicated prolonged pregnancy (equal or more than 42 weeks), and to determine the proper approach to have an optimal outcome. Two groups of women who came to labour ward were managed, these comprised the study group which represents those women with gestational between 37 and 41 weeks. The number of the study group was 126 and of the control was 252 patients. The variables studied were mode and initation of delivery and maternal and neonatal outcome, statistical analysis was done using Chi-square test, t-test and Fisher-test. The incidence of prolonged pregnancy (3.6 percent) among a total of 3500 pregnancies during this period. Women more than 35 years showed an incidence (18.25 percent) and women less than 20 years showed an incidence (18.75 percent). No significant association was obseved between parity and prolonged pregnancy. The gestational age was 42.62 plus or mines 0.018 for the study population and 39.75 plus or mines 0.25 for the control. The rate of caesarean section (C/S) for the study population and control was (7.92 percent) and (15. 87 percent) respectively. This was statistically insignificant. The rate of caesarean section among women who went into spontaneous labour was 3.71 percent compared to 10.36 in inducodeas which was statistically insignificant. Women who were induced had a caesarean section rate of 8.33 percent compared to 3.7 percent which was insignificant. Of the study group the induced women had more duration of labour, (22.23 percent) had duration of labour more than 12 hours compared to (11.12 percent) for spontaneous parturients which was significant. Macrosomia represents 30 percent of indications for (C/S) in study group compared to (12.5 percent) for control which was significant. Women whose age was more than 35 year had more rates of induction, caesarean section and instrumental deliveries. The rates of still birth, neonatal death, congenital malformation and shoulder dystocia were more among the study population when compared to the control and the difference was significant. Perinatal loss was (5.57 percent) for cases compared to (0.79 percent) for control, which was significant. The maternal complications in the form of perineal tear and postpartum haemorrhage, were (2.37 percent) compared to (0.0 percent) among control. It was concluded that, prolonged pregnancy was associated with more C/S due to macrosomia and more perinatal loss, It was also concluded that induction of labour was not associated with better outcome. It was observed that the increase in C/S rate and instrumental delivery was associated with increasing maternal age more than 35 Years.