Study of Maternal and Fetal Outcomes between 37 To 42 Weeks of Pregnancy.

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Study of Maternal and Fetal Outcomes between 37 To 42 Weeks of Pregnancy.

Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 6

Abstract

Background :The ACOG in 2013 redefined term pregnancy as Early term: 37 0/7 weeks through 38 6/7 weeks ,Full term: 39 0/7 weeks through 40 6/7 weeks, Late term: 41 0/7 weeks through 41 6/7 weeks and Post term: 42 0/7 weeks and beyond . Recent data demonstrate that maternal and neonatal adverse outcome rates are not the same across the 5-week gestational age range that constitutes term. Rather, the frequency of adverse outcome is U-shaped with the nadir around 39 weeks 0 days through 40 weeks 6 days gestation. Aim : to assess maternal and neonatal outcomes between 37 to 42 completed weeks of pregnancy and to determine the mean duration of normal pregnancy in regional population with reference to the incidence of reassuring fetal status. Methods : observational study of 460 singleton pregnancies with well documented dates by clinical history and early USG dating. Results: Of the 460 cases included in the study 40% were in 40-41wks of gestational age group followed by 34% in 39-40wks of gestational age, 1.7% are >42 wks gestational age. 75% of pregnancies delivered spontaneously within ±1 week of EDD . Among the primigravida 40% delivered at gestational age 40-41wks followed by 32% in 39-40wks of gestational age. Instrumental deliveries are maximum at 41 – 42 wks of gestation(36.5%). Expectant management at 40 to 41 wks was associated with lower incidence of C.sections as compared to induction of labour.(10.6% vs 26.2%). At 41-42 weeks of gestational age induction of labour decreased caesarean section rate (11% in the induction group compared with 45% in the expectant group).The incidence of meconium stained liquor increased from 13.5% at 38 +6days to 65.5 % at 40+6 daysThe incidence of NICU admissions increased from 17 % to 56.2% between 38 wks to 41 wks of gestation. Conclusion: As gestation age advances from 37 to >42 wks, rate of normal vaginal deliveries decreases and rate of instrumental vaginal deliveries and caesarean section increases. Adverse fetal outcome increases as gestation advances from 37 to >42 weeks of gestation with meconium stained liquor seen in 13% of pregnant women delivered at 37 weeks of gestation as compared with 100% at 41 + wks of pregnancy.

Authors and Affiliations

Dr. S. Rani Reddy

Keywords

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EP ID EP376566
DOI 10.9790/0853-1706085458.
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