Expectant management of post-term patients: observations and outcome.
Post-term pregnancy is associated with increased perinatal mortality. In a retrospective study based on our post-term protocol from 1990 until May 1995 1,798 post-term pregnant women with reliable dating were evaluated for expectant management. A group of 2,633 pregnant women who delivered between 37 and 41 weeks during 1994 served as a control group. The perinatal mortality (0.56 per 1,000 vs. 0.75 per 1,000 in the control group) was similar in both groups. The incidence of induction of labor (7.45% vs. 7% in the control group), meconium of more than +1 (5.2% vs. 4% in the control group), shoulder dystocia (0.33% vs. 0.19%), high birthweight (> 4,500 g) (1% vs. 1%), and cesarean section rates (7.5% vs. 7% in the control group) were similar. However the fetal distress rates (11.6% vs 16%; P = .004), instrumental deliveries (10.1% vs. 13%, P = .002), and the rate of 5-minute Apgar score of less then 7 (1.1% vs. 5%, P = .000001) were found to be significantly lower in the post-date group than in the control group. We conclude that the expectant management and our intensive observation and follow-up in post-term is indicated for both mother and fetus.
Weinstein
D
D
Department of Obstetrics and Gynecology, Hadassah University Hospital, Ein-Karem, Jerusalem, Israel.
Ezra
Y
Y
Picard
R
R
Furman
M
M
Elchalal
U
U
D001034:Apgar Score; D001724:Birth Weight; D015331:Cohort Studies; D004420:Dystocia; D005260:Female; D005316:Fetal Distress; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007557:Israel; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011273:Pregnancy, Prolonged; D012189:Retrospective Studies