Comparison of Induction at 40+10 Weeks with Induction at 40 weeks for Caesarean Section Rate and Perinatal Outcome in Postdate Pregnanciess

Almas Yasmeen; Rakhshanda Aslam; Fareeha .; Laraib Malik; Hira  Shafaqat; Sana  Tariq

doi:10.51253/pafmj.v75i1.10230

Authors

Almas Yasmeen Department of Gyane & Obs, Pakistan Air Force Hospital, Islamabad Pakistan
Rakhshanda Aslam Department of Gyane & Obs, Pakistan Air Force Hospital, Islamabad Pakistan
Fareeha . Department of Gyane & Obs, Pakistan Air Force Hospital, Islamabad Pakistan
Laraib Malik Department of Gyane & Obs, Pakistan Air Force Hospital, Islamabad Pakistan
Hira Shafaqat Department of Gyane & Obs, Pakistan Air Force Hospital, Islamabad Pakistan
Sana Tariq Department of Anesthesia, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i1.10230

Keywords:

Comparison; Induction of labor; Postdate pregnancies.

Abstract

Objective: To compare caesarean section rate and perinatal outcome among women with postdate pregnancies having one previous scar induced at 40+10 weeks and 40 weeks

Study Design: Quasi-experimental study.

Place and Duration of Study Obstetrics department, Pak Emirates Military Hospital Rawalpindi, Pakistan from Jan to Jun 2022

Methodology: The study was conducted on women with one previous scar who were booked cases in our department and did not have spontaneous vaginal delivery till 40 weeks of gestation. They were divided into two groups. One group had an induction of labor at 40 weeks, while the other had an induction at 40+10 weeks. Clinical parameters like rate of Caesarean section for delivery, meconium aspiration, hypoxic-ischemic encephalopathy, and meconium-stained liquor were compared in both groups.

Results A total of 413 women with one previous scar and post-dated pregnancies were recruited for this study. Two groups were made for comparison. 182(44.1%) mothers had induction at 40 weeks, while 231(55.9%) had induction at 40+10 weeks. 208(50.3%) had a vaginal birth after the caesarean section, while 205(49.7%) underwent a Caesarean section. Statistical analysis revealed that more caesarean rate, meconium aspiration, hypoxic-ischemic encephalopathy, and meconium-stained liquor were found in the 40+10 weeks group (p-value<0.05).

Conclusion Induction at 40 weeks turned out to be a better option in women with postdate pregnancies when compared to induction at 40+10 weeks in terms of rate of Caesarean section, meconium aspiration, meconium stained liquor, and hypoxic-ischemic encephalopathy.

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References

Al-Wassia H, Saber M. Admission of term infants to the neonatal intensive care unit in a Saudi tertiary teaching hospital: cumulative incidence and risk factors. Ann Saudi Med 2017; 37(6): 420‐424.

https://doi.org/10.5144/0256-4947.2017.420

Quddusi AI, Razzaq A, Hussain S, Hussain A. Pattern of neonatal admission at the Children’s Hospital and the Institute of Child Health, Multan. J Ayub Med Coll Abbottabad 2012; 24(2): 108–110.

Chow S, Chow R, Popovic M. A Selected Review of the Mortality Rates of Neonatal Intensive Care Units. Front Public Health 2015; 3(3): 225.

https://doi.org/10.3389/fpubh.2015.00225

Tang J, Gou W, Fu Y, Li K, Guo X, Huang T, et al. Association between postterm pregnancy and adverse growth outcomes in preschool-age children. Am J Clin Nutr 2022; 116(2): 482-490.

https://doi.org/10.1093/ajcn/nqac127

Lesvenan C, Simoni M, Olivier M, Winer N, Banaszkiewicz N, Collin R, et al. Prolonged and post-term pregnancies: a regional survey of French clinical practices. Gynecol Obstet Fertil Senol 2021; 49(7-8): 580-586.https://doi.org/10.1016/j.gofs.2021.02.007

Modrzyńska A, Radoń-Pokracka M, Płonka M, Adrianowicz B, Wilczyńska G, Nowak M, et al. Labor induction at full-term and post-term pregnancies. Folia Med Cracov 2019; 59(4): 79–94.

Middleton P, Shepherd E, Morris J, Crowther CA, Gomersall JC. Induction of labour at or beyond 37 weeks' gestation. Cochrane Database Syst Rev 2020; 7(7): CD004945.

https://doi.org/10.1002/14651858.CD004945.pub5

Keulen JK, Bruinsma A, Kortekaas JC, van Dillen J, Bossuyt PM, Oudijk MA, et al. Induction of labour at 41 weeks versus expectant management until 42 weeks (INDEX): multicentre, randomised non-inferiority trial. BMJ 2019; 364(7): l344.

https://doi.org/10.1136/bmj.l344

Wennerholm UB, Saltvedt S, Wessberg A, Alkmark M, Bergh C, Wendel SB, et al. Induction of labour at 41 weeks versus expectant management and induction of labour at 42 weeks (SWEdish Post-term Induction Study, SWEPIS): multicentre, open label, randomised, superiority trial. BMJ 2021; 375: 3072. https://doi.org/10.1136/bmj.l6131

Shahza N, Akram N, Hanif A. Induction of labor in postdate pregnancies a comparative study between isosorbide mono nitrate plus misoprostol vs misoprostol alone as a method of induction of labor. J Uni Med Dental Coll 2015; 6(1): 36-40.

Deng K, Huang Y, Wang Y, Zhu J, Mu Y, Li X, et al. Prevalence of postterm births and associated maternal risk factors in China: data from over 6 million births at health facilities between 2012 and 2016. Sci Rep 2019; 9(1): 273.

https://doi.org/10.1038/s41598-018-36290-7

Vitale SG, Marilli I, Rapisarda AM, Iapichino V, Stancanelli F, Cianci A. Diagnosis, antenatal surveillance and management of prolonged pregnancy: current perspectives. Minerva Ginecol 2015; 67(4): 365-373.

Anh ND, Duc TA, Ha NT, Giang DT, Dat DT, Thuong PH, et al. Dinoprostone Vaginal Insert for Induction of Labor in Women with Low-Risk Pregnancies: A Prospective Study. Med Arch 2022; 76(1): 39-44.

https://doi.org/10.5455/medarh.2022.76.39-44

Karataşlı V, Kanmaz AG, İnan AH, Budak A, Beyan E. Maternal and neonatal outcomes of adolescent pregnancy. J Gynecol Obstet Hum Reprod 2019; 48(5): 347–350.

Darney BG, Snowden JM, Cheng YW, Jacob L, Nicholson JM, Kaimal A, et al. Elective induction of labor at term compared with expectant management: maternal and neonatal outcomes. Obstet Gynecol 2013; 122(4): 761-769.

https://doi.org/10.1097/AOG.0b013e3182a6a4d0

Wennerholm U-B, Hagberg H, Brorsson B, Bergh C. Induction of labor versus expectant management for post-date pregnancy: is there sufficient evidence for a change in clinical practice? Acta Obstet Gynecol Scand 2009; 88(1): 6–17.

Bruinsma A, Keulen JK, Kortekaas JC, van Dillen J, Duijnhoven RG, Bossuyt PM, et al. Elective induction of labour and expectant management in late-term pregnancy: A prospective cohort study alongside the INDEX randomised controlled trial. Eur J Obstet Gynecol Reprod Biol X 2022; 16(3): 100165. https://doi.org/10.1016/j.eurox.2022.100165

Middleton P, Shepherd E, Crowther CA. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev 2018; 5(5): CD004945.

https://doi.org/10.1002/14651858.CD004945.pub4