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      The Fetomaternal Outcome in Pregnancy beyond 40 Weeks of Gestation at a Tertiary Center

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          ABSTRACT

          Aims and background

          Any pregnancy duration extending beyond 294 days is prolonged. These pregnancies do have higher chances of complications. Pregnancies beyond 40 weeks or 280 days are also associated with compromised fetomaternal outcomes. This study aims to evaluate the fetomaternal outcome in pregnancies after 40 weeks of gestation.

          Materials and methods

          In this prospective observational study of 14 months duration, both primigravida and multigravida crossing 40 weeks of pregnancy were included. Complicated pregnancies and fetal anomalies were excluded. The spontaneous labor or induction rate, mode of delivery, and fetomaternal complications were evaluated. The statistical analysis was done using SPSS software.

          Results

          Most primigravidas needed induction of labor compared to multigravida. The induced group had higher cesarean section rates, 59.37%, than the spontaneous group, 19.44%, which is statistically significant. Maternal morbidities at <40 weeks pregnancies are found in 16.58% of cases and 29.6% of cases between 41 and 42 weeks. Perinatal morbidity is seen in 35.7% of pregnancies in less than 41 weeks and 100% of cases crossing 42 weeks.

          Conclusion

          Pregnancies beyond 40 weeks are associated with higher complication rates, which increase as gestational age (GA) increases.

          Clinical significance

          All pregnancies beyond 40 weeks should be categorized as high risk and monitored intensively.

          How to cite this article

          Botcha H, Agrawal S, Dora AK. The Fetomaternal Outcome in Pregnancy beyond 40 Weeks of Gestation at a Tertiary Center. J South Asian Feder Obst Gynae 2023;15(3):278–282.

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          Most cited references18

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          Postterm pregnancy

          Postterm pregnancy is a pregnancy that extends to 42 weeks of gestation or beyond. Fetal, neonatal and maternal complications associated with this condition have always been underestimated. It is not well understood why some women become postterm although in obesity, hormonal and genetic factors have been implicated. The management of postterm pregnancy constitutes a challenge to clinicians; knowing who to induce, who will respond to induction and who will require a caesarean section (CS). The current definition and management of postterm pregnancy have been challenged in several studies as the emerging evidence demonstrates that the incidence of complications associated with postterm pregnancy also increase prior to 42 weeks of gestation. For example the incidence of stillbirth increases from 39 weeks onwards with a sharp rise after 40 weeks of gestation. Induction of labour before 42 weeks of gestation has the potential to prevent these complications; however, both patients and clinicians alike are concerned about risks associated with induction of labour such as failure of induction and increases in CS rates. There is a strong body of evidence however that demonstrates that induction of labour at term and prior to 42 weeks of gestation (particularly between 40 & 42 weeks) is associated with a reduction in perinatal complications without an associated increase in CS rates. It seems therefore that a policy of induction of labour at 41 weeks in postterm women could be beneficial with potential improvement in perinatal outcome and a reduction in maternal complications.
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            First- vs second-trimester ultrasound: the effect on pregnancy dating and perinatal outcomes.

            The objective of the study was to examine the effect of first-trimester obstetric ultrasound (OBUS) on the measurement of the effect of complications ascribed to postterm pregnancies.
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              Feto-maternal outcome in pregnancy beyond 40 weeks

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                Author and article information

                Contributors
                Journal
                JSAFOG
                Journal of South Asian Federation of Obstetrics and Gynaecology
                JSAFOG
                Jaypee Brothers Medical Publishers
                0974-8938
                0975-1920
                May-June 2023
                : 15
                : 3
                : 278-282
                Affiliations
                [1,2 ]Department of Obstetrics and Gynecology, Jawaharlal Nehru Hospital and Research Centre, Bhilai, Chhattisgarh, India
                [3 ]Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
                Author notes
                Arun Kumar Dora, Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India, Phone: +91 7000472202, e-mail: arundora@ 123456gmail.com
                Article
                10.5005/jp-journals-10006-2252
                231b1c79-1636-4d5a-b22f-848f0317dc90
                Copyright © 2023; The Author(s).

                © The Author(s). 2023 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 11 May 2023
                : 01 June 2023
                : 31 July 2023
                Categories
                ORIGINAL RESEARCH
                Custom metadata
                jsafog-15-278.pdf

                Obstetrics & Gynecology
                Post-dated pregnancy,Prolonged pregnancy,Post-term pregnancy,Postdatism,Beyond 40 weeks of pregnancy

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