The Outcome of Combined Induction of Labor in Post Dated Pregnancy

Introduction: Postdated and prolonged pregnancy are accepted terms by WHO and the International Federation of Gynecology and Obstetrics to describe pregnancy beyond dates (expected date of delivery). It complicates up to 10% of all pregnancies and carries an increased risk to the mother and fetus. This study aimed to analyze the outcome of combined induction of labor in post-dated pregnancy. Methods: This prospective interventional study was conducted at the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Bangladesh, from March 2013 to August 2013. A total of 50 patients with post-dated pregnancies were selected as study subjects by purposive sampling technique. In this study, 34.0% of patients' labor induction was given by oxytocin drip followed by ARM, and 20.0% of patients' labor induction was given by ARM followed by oxytocin drip. In 46.0% of patients with an unfavorable cervix, prostaglandin was used followed by ARM. Collected data were analyzed using different methods of statistics. Statistical analyses were carried out by using the Statistical Package for Social Sciences version 20.0 for Windows. Result: It was observed that intrapartum fetal distress occurred in a total of 12 babies. 10 babies needed resuscitation and 40 babies needed no resuscitation. In this series, among the healthy babies majority (20) were born at 40 completed weeks of gestation, 18 babies at 41 completed weeks, and 2 babies were born at 42 completed weeks of gestation. Among the asphyxiated baby 6 babies were borne at 42 completed weeks of gestation, no one at 41 completed weeks, and 2 asphyxiated babies were borne at 40 completed weeks of gestation. All babies with other complications like LBW, birth trauma, and post-maturity syndrome. Conclusion: This study concludes most frequent indication was fetal distress and unfavorable cervix in postdated pregnancy. Abnormal uterine action and asphyxiated baby were the more frequent maternal and fetal complications respectively. A small number of LBW, birth trauma, and post-maturity syndrome were observed but no maternal and fetal death was found in this study.