Neonatal Outcome in Post-term Pregnancy

Objective: The aim of this study was to evaluate the neonatal outcome among the pregnant women who delivered after post-term pregnancy. Design: A descriptive case series. Place & duration of study: The study was conducted at Gynae Unit I, Allama Iqbal Medical College/Jinnah Hospital, Lahore from January 2009 till September 2009. Material & methods: The study comprised of 60 patients with 42 weeks of gestation or beyond. Patients with intrauterine demise, medical disorders, or pregnancy complications were not included in the study. Parameters of poor neonatal outcome were identified. Variables like age, parity, gestational age, fetal movement, past prolonged pregnancy, ultrasound & admission CTG findings and mode of delivery were studied. Results: Majority of the patients 36.67% (n=22) were between 20 - 25 years of age. In the study group primigravida and multi gravida were found in 45.67% (n=25) and 58.33% (n=35) respectively. Gestational age for the patients included in the study was more than 42 weeks in 75% (n=45). Decreased fetal movements were recorded in 50% (n=30). The mode of delivery was spontaneous vaginal in 18.33% (n=11), instrumental vaginal in 11.67% (n=7), emergency caesarean section in 66.67% (n=40) and elective caesarean section in 3.33% (n=2). Male babies born were 66.67% (n=40) and female babies were 33.33% (n=20). Majority of the babies 63.33% were admitted to the neonatal ICU. The maximum stay in ICU was 7 days for one baby. Three babies had birth trauma. Among the fetal complications meconium aspiration syndrome was most common which was found in 68.33% (n=41), followed by asphyxia neonatorum in 55% (n=33), respiratory distress syndrome in 48.33% (n=29), jaundice neonatorum in 8.33% (n=5) and sepsis neonatorum in 6.67% (n=4). There was no fetal mortality. Conclusion: Pregnancy should not be allowed to go post-term due to association of higher neonatal morbidity and mortality rate, and should be managed before 42 weeks of gestation