Assesing the Outcomes of Prolonged Pregnancy

Simin Taavoni

Assesing the Outcomes of Prolonged Pregnancy

Simin Taavoni

2003

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8 pages

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Background: Lengthened pregnancy after the 41st week will create problems for mother, fetus and newborn. Assessing the outcomes of prolonged pregnancy are research priorities. Objective: To determine the maternal, fetal and neonatal outcomes of prolonged pregnancy. Design: This was a case-control study in which the data were collected through record sheets. Sample: There were 1800 samples in this research of which 600 women (prolonged pregnancy) made the case group and were selected through continuous sampling. Control group included 1200 women (normal pregnancy) which were chosen by simple random sampling. Result: The findings indicated there was significant relationship between maternal outcomes (i.e. such as induction of labour, responding to induction in the 1st and 2nd days, spontaneous and cesarean child birth, postpartum hemorrhage, and duration of second stage of delivery) and prolonged pregnancy (P<0.05). There were also significant relationship between prolonged pregnancy and fetal outcomes such as fetal distress, meconium passage, decreased fetal movements in admission time, and decreased volume of amniotic fluid (P<0/05). Regarding to neonatal outcomes, there was a significant relationship between prolonged pregnancy and admission in neonatal intensive care unit (NICU), and infant weight at birth (P< 0.05). Conclusion: Based on the findings, increased labour induction, responding to induction in the second day, preference of child birth through cesarean, increased postpartum hemorrhage, prolonged second stage of delivery, fetal distress, meconium passage, decreased fetal movements in admission time, decreased volume of amniotic fluid, and increased infant birth weight were known adverse outcomes of prolonged pregnancy. Therefore, the termination of prolonged pregnancy after 41st is recommended. This termination is recommended to be done at areas equipped with special cares and facilities (i.e. child birth, after child birth, infant resuscitation, and NICU facilities).

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" ` % ,)B Abotalib !)",4 ./0 '*" "C ,' c, % &% , 5(^ ^ 4 U % (ppM) ', mC 678 c0 !" .G " <'E % B = ',# ",` +, "# - " x0 8 #' = % !"# + ' 6 $=") AG $m"# ,"# PU , - , b," "@ A , a, 6 Luckas $(ej) ',, /,, + , 4 U ,, ^ ,, - , ', O," ]," (fXXX) Ratcliff (eqq) % vB !"# B% :^ n' '"t !" 4 ./0 '> 678 % ./, ,# &% , } C % + % &% , 6],G (ppK) Divon , 4 U % 4 /,F . < * !"# B% :^ n' eqq $Divon , 4 U % ! '"^ + +, KR = c 0 c % ,; G % ',> , 4 U ',E B ./G'E %'H 0%' % c ,B , , = , O', A",0 {U0 % '*" m ./ # + ! % m , & - " 678 =0 c0 } C % % <7, & /CH' 6Q % \'98 "` + "#$ ! + + ( ) *% &' Downloaded from ijn.iums.ac.ir at 3:47 IRST on Sunday November 28th 2021 $'( $( <v,* m*78 % <% * "B` ='3 V kF 8 % ='3 `% ` ' v]8 =F < * &% 0'8 $, <, 67,8 !, = % % ` <v* Q ` . &%]0 J0 )" * !",*G ",0 ,B#' $] 0% .(ws) .' "4 / $',dy d,0 /' ' $'d $c y $= #$ % )B $ G' .w-K $P',,N"E $.m,,# ,,` $,,4 $.5 $/,, E $.&% ,,E 5 $= ,,d" .] ," ,B &%% .(wK).O ` $='0 $.m0 m# $ $.m0 c +% * $'d $c y $= # $% )B d# > H ='d B#' .KR-KRw $sRK-sL $ CE Abotalib, ZM., Soltan, M.H.,Chowdhury, N., Adelusi, B. (1996). Obstetric outcome in uncomplicated prolonged pregnancy. Inter J Ob & Gyn. 55: 225-230. Campbell, MK. (1997). Factors affecting outcome in Post-term Birth. Current Opinion in Obstet & Gynecol. 9: 356-360. Divon, MY. (1998). Fetal and neonatal mortality in the Post-term Pregnancy: The Impact of gestational age and fetal growth restriction. Am Obstet Gynecol. 178: 726-731. James, M., Draycott, T., Fox, R., Read, M. (1999). Obstetric & Gynecol: A Problem Solving Approach. Edinburgh, WB Saunders Co. 242-245. Luckas, M., Buckett, W., Alfirevic, Z., (1998). comparison of outcomes in uncomplicated term and post-term pregnancy following spontaneous labor. J Perinal Med. 26: 475 - 478. Ratcliff, SP. (2000). Family Practice Obstetrics. 2nd ed. Philadelphia, Hanley & Belfus. 313-328. Roach, VJ., Rogers, MS. (1997). Pregnancy outcome beyond 41 weeks Gestation. Inter J Ob & Gyn, 59:19-28. Scott, JR., Disaia, PHJ., Hammod, CHB., Spellacy, WN. (1999). Danforths' Ob & Gyn. 8thed. Philadelphia: A WolterKluwer Co, 287-292. Wong, D. (2001) Maternal Child Nursing Care. 2nd ed. St. Louis: Mosby Hacourt Health Sciences Co, 438444. "#$ ! + + = , % , !4 !"# '0 1 U =F :"4 !%]0 /0 .'"E % <7, & ,/,CH' 6Q % \'98 /F U % % , , @ 678 & G + T, /,F , <7, & /CH' 6Q % \'98 !" !"# B% :^ % '"^ !"# '0 P= L/LM ," ' , ) % ,# % , } ,C % +, \'98 ` m ! .(OR=R/Mp $P =L/LL OR=/M$ !",# ',0 T, :,"4 <7 & /CH' 6Q % +, <'E % !"# B% :^ % '"^ $!",# ',#) , \'9,8 :F ' 0 U % % . 'B 5(,^ <',E !", (!"# &% !"# # E%] % ,)B Luckas, 4 U % .,* < ,* &% , 6Q % \'98 :F % &% + ]" $(ppK) /,F , ,U % % .,* < * <'E % <7 & /CH' % , "4 B <7 & /CH' 6Q % \'98 % , !,4 , !",# '0 1 U =F :"4 !%]0 ?H % , % % , !4 % !"# '0 hH c B $'E ' , 4 U % 0% m 'z ./0 '*" T :")* "C & ,/,CH' 6,Q % \'98 '*" /F '> , % !",# ,B% :,^ ,% '"^ , :,"4 <7 ,E%] ,B + % ! $ "C % !",# B% :^ % '"^ /0 ' A !"# # ./0 '*" "C ,>%F , ! 678 - ! # $ B &]'^ $!%]0 \% B = _B !, a^ 94 $/0 '*" + % !"# '# =,H !, , d*"8 :CH ? /,d# <7, & ,/,CH' + , ) , ],d ]' % <7, & ,/,CH' 6,Q , V " $ B $ B .'"E = + m m - d '> 678 % ` @ /,d# m,*78 , m, d,*"8 /,G'E %'H m0%' % m, m , m 0 /d# hQ O \% m0%' ,'3 h,Q O , \% '"D , m,0%' !",_B + . = m ? ! HF ' B -2 , ASSESING THE OUTCOMES OF PROLONGED PREGNANCY Downloaded from ijn.iums.ac.ir at 3:47 IRST on Sunday November 28th 2021 Oskouie, SF.Ph.D1 Ramezani, KH.MS2 Taavoni, S.MS3 Hagghani, H.MS4 ABSTRACT Background: Lengthened pregnancy after the 41st week will create problems for mother, fetus and newborn. Assessing the outcomes of prolonged pregnancy are research priorities. Objective: To determine the maternal, fetal and neonatal outcomes of prolonged pregnancy. Design: This was a case -control study in which the data were collected through record sheets. Sample: There were 1800 samples in this research of which 600 women (prolonged pregnancy) made the case group and were selected through continuous sampling. Control group included 1200 women (normal pregnancy) which were chosen by simple random sampling. Result: The findings indicated there was significant relationship between maternal outcomes (i.e. such as induction of labour, responding to induction in the 1st and 2nd days, spontaneous and cesarean child birth, postpartum hemorrhage, and duration of second stage of delivery) and prolonged pregnancy (P<0.05). There were also significant relationship between prolonged pregnancy and fetal outcomes such as fetal distress, meconium passage, decreased fetal movements in admission time, and decreased volume of amniotic fluid (P<0/05). Regarding to neonatal outcomes, there was a significant relationship between prolonged pregnancy and admission in neonatal intensive care unit (NICU), and infant weight at birth (P< 0.05). Conclusion: Based on the findings, increased labour induction, responding to induction in the second day, preference of child birth through cesarean, increased postpartum hemorrhage, prolonged second stage of delivery, fetal distress, meconium passage, decreased fetal movements in admission time, decreased volume of amniotic fluid, and increased infant birth weight were known adverse outcomes of prolonged pregnancy. Therefore, the termination of prolonged pregnancy after 41st is recommended. This termination is recommended to be done at areas equipped with special cares and facilities (i.e. child birth, after child birth, infant resuscitation, and NICU facilities). Key Words: Prolonged pregnancy, Outcomes of prolonged pregnancy, Maternal outcomes, Fetal outcomes, Neonatal outcomes. 1 Assistant Professor (Ph.D), School of Nursing and Midwifery, Iran University of Medical Sciences and Health Services, Tehran, Iran 2 MS in Midwifery ( Corresponding Author) 3 Senior Lecturer, School of Nursing and Midwifery, Iran University of Medical Sciences and Health Services, Tehran, Iran 4 Senior Lecturer, School of Management and Medical Information , Iran University of Medical Sciences and Health Services, Tehran, Iran VOL 16, NO 34, Summer 2003 JIN58

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