COMPARISON OF FETOMATERNAL OUTCOMES IN TERM PREGNANCIES BEFORE AND AFTER 40 WEEKS
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Keywords
Post-Dated Pregnancy, Term Pregnancy, Fetomaternal Outcome, NICU Admission, Meconium Aspiration, Cesarean Section, Postpartum Hemorrhage.
Abstract
: Post-dated pregnancy, defined as gestation extending beyond 40 weeks, is associated with increased maternal and perinatal risks such as oligohydramnios, macrosomia, meconium aspiration, fetal distress, PPH (Post-Partum Haemorrhage), and elevated rates of operative delivery. This study compares fetomaternal outcomes between pregnancies before 40 weeks and those extending beyond 40 weeks in order to guide timely obstetric interventions.
Methods: A prospective cohort study was conducted at the Regional Institute of Medical Sciences, Imphal, from May 2023 to October 2024. A total of 106 adult pregnant women were enrolled and divided into two groups: post-dated pregnancies (>40 weeks) and term pregnancies (37–40 weeks), each comprising 53 participants. Women with medical disorders, prior cesarean section, congenital anomalies, malpresentation, and multifetal gestations were excluded. Data on maternal demographics, type of labor, induction method, mode of delivery, neonatal outcomes, and complications were recorded. Statistical analysis was performed using SPSS v26, with p < 0.05 considered significant.
Results: Post-dated pregnancies showed higher rates of induction (49% vs. 22.6%) and cesarean section (35.85% vs. 11.32%). Severe oligohydramnios (36.8%) and cephalopelvic disproportion (26.3%) were the leading indications for caesarean delivery in the >40-week group. Meconium-stained liquor was significantly more common in post-dated pregnancies (65.38% vs. 15.09%, p < 0.05). PPH occurred in 34% of post-dated women compared to 7.5% in controls (p = 0.00185). The mean birth weight was higher in the post-dated group (3.23 kg vs. 3.05 kg, p = 0.018). NICU admissions were significantly increased among post-dated neonates (14 vs. 4, p = 0.01), primarily due to meconium aspiration syndrome and birth asphyxia. Lower APGAR scores were more frequent in the post-dated group.
Conclusion: Pregnancies extending beyond 40 weeks are associated with significantly higher maternal and neonatal morbidity, particularly due to increased operative delivery, PPH, meconium aspiration, and NICU admissions. Timely monitoring and induction around 40 weeks may help reduce adverse outcomes.
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Dr. Saiprittam Kar
Senior Resident, Department of Obstetrics & Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Dr. Telen Thangkhojam Kom
Associate Professor, Department of Obstetrics & Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Dr. Victor Khuman
Assistant Professor, Department of Obstetrics & Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Dr. L. Bimolchandra Singh
Professor, Department of Obstetrics & Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur, India.
