In The Name of GOD

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In The Name of GOD
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Evaluation Of Neonatal outcomes in women with
prolonged PregnancySarafraz. N Bagheri. A
Kafaee.M Abbaszadeh.FDepartment of midwifery,
kashan university of medical sciences and Health
services, Iran.
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Background

• Prolonged pregnancy is defined as pregnancy that
  has reached 42 weeks of completed gestation from
  the first day of the LMP or 40 weeks gestation
  from the time of conception.It occurs in
  approximately 10 of pregnancies.

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Prolongation of pregnancy increase the fetal
complications. Such as placental insufficiency,
Intrauterine death, fetal distress, meconium
aspiration and Delivery trauma.
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The purpose of this study was to indicate
neonatal outcomes after 40 weeks gestational age
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In this descriptive study 450 pregnant women
that their gestational age were 40 weeks or more
selected according to history or sonography.

Materials and Methods
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Inclusion criteria were full term and normal
pregnancy . The parturient patients with
systemic disease, PROM, Placenta previa or
Abruptio placenta , preeclampsia , twin or
multiple pregnancies were excluded from the study.
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They were hospitalized for termination of
pregnancy in shabihkhani Hospital in Kashan,
Iran, between April 2004 and April 2005.Neonatal
outcomes such as fetal distress, meconium, 5
minutes APGAR score , hospitalization in NICU and
weight were studied.
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Relevant data were collected through observation
and interview checklists.Statistical analysis
was done using student T test, X2 test and also
mann-withney test for comparison.
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RESULTS
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Table 1 frequency of gestational age according
to maternal age
P- 0.48
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Table 2 frequency of fetal distress according
to gestational age
P- 0.11
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Table 3 frequency of meconium staining according
to gestational age
P-0.52
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Table 4 frequency of 5 minutes APGAR score
according to gestational age
P- 0.62
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Table 5 frequency of neonate hospitalization
according to gestational age
P- 0.76
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Table 6 frequency of dystocia according to
gestational age
P- 0.66
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Table 7 frequency of birth weight according to
gestational age
P- 0.77
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Discussion

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In this study fetal distress occurred only in
5.8 that confirm other researches findings
that showed fetal distress occurred after 42
weeks. (Treger, 2002 oboro et al,2005)
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There was not observed any significant difference
between the meconium staining and gestatinal age
(p0.52), James, et al(2001) found increase in
meconium staining after 41 weeks and 4 days. He
suggested terminate of pregnancy after 41 weeks .
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Based on this study fifth minute APGAR was
excellent in 99 of neonate. Alexander,et
al(2000) and cautey, et al (2005) found that
fifth minute APGAR has not been changed
significantly in 40 week, 40 to 41 week, and 41
to 42 week.
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according to our results the correlation between
neonatal hospitalization and gestational age was
not significant (P0.76), Alexander, et al (2000)
results indicated that neonatal hospitalization
and sepsis increase after 42 weeks but in kautey
et al ,(2005) research a significant correlation
was found between the gestational age and NICU
hospitalized.
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Our results showed that there was no significant
relationship between gestational age with fetal
weight (over 4 kg) and shoulder dystocia that
confirm Ushakiran, et al(2005) findings.
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Recomendation

• As the results of this study, it seems that
  termination of pregnancy is not necessary before
  forty-second week.
• If the biophysical tests indicate that the fetus
  is normal, nothing need be done.
• If placental function is normal , the fetus will
  continue to grow.

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However if the dating of the pregnancy is
accurate , the cervix is favorable, and the
fetus is mature, an attempt can be made to
induce labor at 42 week.

• If the induction is unsuccessful or
  contraindicated, cesarean section may be
  indicated.

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THE END