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Volume 12 Issue 4 ( October-December ) 2023

Original Articles

Fetomaternal outcome of postdated pregnancies and role of Dinoprostone in a tertiary care center of West Bengal
Dr. Sannyasi Charan Barman, Dr. Achinta Mandal, Dr. Kajal Kumar Patra, Dr. Kishore PMadhwani

Background: Postdated pregnancy is one of the most prevalent types of childbirth. A pregnancy is referred to as postdated if it lasts longer than 40 weeks. After 41 weeks, the fetus is more at risk for various conditions, including meconium aspiration, oligohydramnios, which increases the risk of cord compression, declining placental function, and increasing fetal weight. The main objective of the studywas to evaluate the fetomaternal outcome of postdated pregnancies and role of Dinoprostone gel in a tertiary care center of West Bengal. Methods : This prospective longitudinal observational study was conducted at BS Medical College, Deptt. of (G&O) from June 2020 to May 2021, among 446 low risk pregnant women with well established GA ≥ 40 weeks and carrying a single, live intrauterine fetus in cephalic presentation. In this study 220 patients were included in study groupand they were induced with Dinoprostone gel, maximum 3 such, after 41 0/7 weeks of pregnancy(Study group) and results were compared with expected management group up to 42 0/7 weeks in 226 patients (Control Group). Statistical data were analysed by using Microsoft Excel and SPSS V.20 software. Results : Baseline features were similar in both groups. Induction/admission to delivery interval was 16.246±19.20 hrs in dinoprostone group and 12.56±2.42 hrs in expectantmanagement group with p=0.026. Meconium stained liquor was 88 (40%) and 44 (19.47%) in Dinoprostone and expectant group, respectively, p= 0.000. Abnormal CTG, hyper stimulation ofuterus occurred in 24 (10.91%), 12 (5.45%) cases in Dinoprostone group and 10 (4.42%), 6 (2.65%) cases in expectant group, respectively. Vaginal delivery was 138 (62.73%) and cesarean section was 41 (37.27%) in Dinoprostone group, in comparison to expectant group it was 160 (70.79%) and 66 (29.20%), respectively. 5th min Agar’s score and NICU admission was similar inboth groups. Conclusion : Early induction at 41 weeks and close antenatal monitoring up to 42 weeks show similar outcome in respect to mode of delivery, neonatal morbidity and maternal complications. Dinoprostone is very effective for labour induction but close monitoring is required for early diagnosis of uterine hyper stimulation and fetal heart rate changes.

 
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