Outcome of prolonged pregnancy revisited in a Nigerian tertiary centre.
The study was conducted to evaluate whether routine induction of labour at 41-42 weeks of gestation has an increased risk for operative delivery, maternal or fetal complication compared with spontaneously initiated labour of similar gestation. A case-control study design was used; main outcome measures were caesarean section rate, instrumental delivery and fetal outcome. There was no significant difference in caesarean section rates 36(18.0%) in the induction group, compared with 28(13.8%) in parturient spontaneously initiating labour [P=0.24 odds ratio 95% CI 1.37 (0.78:2.43)]. Instrumental interventions were comparable in the two groups (5.5% and 4.0%). A subgroup analysis of nulliparous women was also not statistically different. Other than higher rates of admission into the neonatal unit in the induction group, fetal outcomes were similar. In conclusion, a routine induction of labour for prolonged pregnancy is safe, having no significant increase in caesarean section or fetal complications. The policy is advocated especially in developing countries, in view of the uncertainty of further prolongation of pregnancy beyond 42 completed weeks.
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Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City, Endo State, Nigeria. wharc@warri.rcl.nig.com
Okonofua
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