Fetal outcome in pregnancies defined as post-term according to the last menstrual period estimate, but not according to the ultrasound estimate.
OBJECTIVE
To study the risk of adverse fetal outcome in fetuses that were post-term according to the last menstrual period estimate but not according to the ultrasound estimate.


METHODS
A total of 11,510 women with singleton pregnancies, reliable last menstrual period and delivery after 37 weeks were divided into four groups: women who delivered at term, i.e. within 259-295 days according to both the ultrasound and the last menstrual period estimate; women who delivered post-term according to the last menstrual period estimate but not according to the ultrasound estimate; women who delivered post-term according to the ultrasound estimate but not according to the last menstrual period estimate; and women who delivered post-term according to both the ultrasound and the last menstrual period estimates. Stepwise logistic regression was used to test whether the risk of Apgar score of < 7 after 5 min and transfer to the neonatal intensive care unit increased in any of the post-term groups.


RESULTS
There was no significant difference in mortality between the term group and the three study groups. There was no significant increase in the risk for Apgar score of < 7 after 5 min or transfer to the neonatal intensive care unit for pregnancies that were defined as post-term according to the last menstrual period estimate but not according to the ultrasound estimate. There was, however, an increased risk for Apgar score of < 7 after 5 min in the group that was post-term according to the ultrasound estimate but not according to the last menstrual period estimate. There was also an increased risk for transfer to the neonatal intensive care unit in the group that was post-term according to both estimates.


CONCLUSIONS
The effect of ultrasound in changing the estimated day of delivery to a later date leading to pregnancies becoming post-term according to the last menstrual period estimate but not according to the ultrasound estimate does not have any adverse consequences for the fetal outcome. However, there seems to be an increased risk for adverse consequences for pregnancies that are post-term according to the ultrasound estimate.
Tunón
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Department of Obstetrics and Gynecology, Trondheim University Hospital, Norway.
Eik-Nes
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Grøttum
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D001034:Apgar Score; D016022:Case-Control Studies; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011273:Pregnancy, Prolonged; D016216:Ultrasonography, Prenatal