Post-term or postdated pregnancy is defined as pregnancy that persists beyond 294 days or 42 weeks of gestation. Its incidence is up to 10% of all pregnancies and carries increased risk to the mother and foetus.
Aim: To study the maternal and foetal outcome in postdated pregnancies.
Materials and methods: This was a retrospective observational study conducted in the department of gynaecology and obstetrics in GMC Jammu for a period of one year. 100 patients in the antenatal ward and labour room were selected for the study and were divided into two groups: Control group- Gestational age 37-40 weeks & Study group - Gestational age >40 weeks. Maternal and foetal complications were compared between the two groups.
Results: Among the study group, 48% of women were between 26-30 years. 62% women were primigravida. There was increased rate of cesarean sections (28%) and instrumental deliveries (8%) in the study group. Acute foetal distress and meconium stained liquor was the most common indication for LSCS seen in 14% cases followed by cephalopelvic disproportion in 6% cases. There was increased incidence of maternal complications like LSCS (28%), PPH (16%) and sepsis (12%). Foetal complications were also increased in the study group like foetal asphyxia (12%), admission into NICU (14%) and intrauterine deaths (2%).
Conclusion: Postdated pregnancy remains a clinical dilemma for an obstetrician. The choice is between watchful expectancy for labour to start or induction in postdated patients. Keeping in mind the increased complications associated with postdatedism, the safe approach seems to be early induction in case of post term pregnancies or careful monitoring by CTG and colour doppler studies if expectant management is decided.