FETOMATERNAL OUTCOME OF PREGNANCY BETWEEN 40 AND 42 WEEKS

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Abstract

.Objective:To evaluatewhether serial monitoring of fetuses beyond 40 weeks with biophysical profile
and non stress test improves the fetal outcome in terms of morbidity and mortality.Design: Prospective control study.
Setting: Department of Obstetrics & Gynaecology at Ittefaq Hospital( Trust) Lahore,. Period: From Jan, 2007 to June
2008.Patients and Methods: Two hundred women with singleton uncomplicated pregnancies at 40 weeks were divided
into two groups; A study group with biweekly biophysical profile and non stress test and a control group with biweekly
antenatal clinical assessment with fetal kick count chart. Main outcome measures were onset of labour, mode of
delivery, Apgar score, presence of meconium and admission to nursery. Results: The age of patients ranged between
18 to 39 years with the mean of 26.33.The range of gravidity was between primigravida to gravida seven. Ninety six
percent of total patients were delivered by 41 weeks and 6 days.18% of women were induced in study group compared
to 11% in control group ( p value=0.124 ).Cesarean section rate was 8% in study group and 11% in control group. Rate
of instrumental deliveries was 6.5% in study group while 11.2% in control group. The difference in mode of delivery was
found to be insignificant ( p=0.538 ).Weights of the babies ranged between 2.6 to 4.4 kg with a mean of 3.246 kg.
Cumulative %age of APGAR score at 5 minutes was more than 6/10 in 92.5% cases ( p=0.665 ).Meconiumwas found
in 18% of cases in study group and 22% of control group( p=0.917 ).12 % of the babies were admitted to nursery in
study group compared to 16% in control group. Perinatal mortality was found to be 10/1000 in control group while there
was no perinatal death in study group. Conclusions: The difference of outcome between two groups was found to be
statistically insignificant which concluded the validity of either mode of management.