Vol 44 # 2 June 2012 - Kma.org.kw

June 2012
KUWAIT MEDICAL JOURNAL 118
Original Article
The Prevalence and Route of Delivery
of Prolonged Pregnancies
Sanam Moradan , Sharbanoo Pahlevany Nejad
Department of Obstetrics and Gynecology, Semnan University Hospital Amir, Semnan, Iran
ABSTRACT
Kuwait Medical Journal 2012; 44 (2): 118 - 120
Objective: To evaluate the prevalence, rate and indications for
cesarean deliveries in prolonged and post-term pregnancies
Design: Prospective descriptive cross-sectional study
Setting: Department of Obstetrics and Gynecology,
University Hospital Amir, Semnan, Iran.
Subjects: One hundred and sixty-four cases of prolonged
pregnancy were encountered during the study period from
September 2009 to September 2010. Data regarding total
deliveries, number of prolonged pregnancies and cesarean
delivery were gathered and the prevalence of prolonged
pregnancy, the cesarean delivery rate and the indications for
cesarean deliveries evaluated.
Main Outcome Measures: Prevalence of prolonged
pregnancies and cesarean delivery rates
Intervention: Delivery and cesarean section
Result: Total deliveries during this period were 1157.
Forty-one and 13 deliveries were beyond 41 weeks
(prolonged pregnancy) and 42 weeks (post term
pregnancy) respectively. The prevalence of prolonged
pregnancy and post term pregnancy was 3.5 and 1.12%
respectively. The cesarean delivery rate for prolonged and
post-term pregnancy were 31.7 and 38.46% respectively.
The most common indications for cesarean deliveries
were failure to progress and meconium staining of
amniotic fluid.
Conclusion: The prevalence of prolonged and post-term
pregnancy was low and the incidence of cesarean section
was high in these cases.The most common indications
for cesarean section were dystocia ( failure to progress)
and meconium staining of amniotic fluid .
KEY WORDS: cesarean delivery, post-term, prolonged, pregnancy
INTRODUCTION
Prolonged pregnancy refers to a pregnancy that has
extended to beyond 42 weeks (294 days) gestation [1] .
This definition is endorsed by the American College
of Obstetricians and Gynecologists (ACOG), the World
Health Organization (WHO) and the International
Federation of Gynecology and Obstetrics. In view
of more recent perinatal mortality data, it would be
reasonable to conclude that prolonged pregnancy
should be defined as gestational age at birth greater
than or equal to 41 weeks of gestation [2] . The etiology of
prolonged pregnancy is unknown. It is associated with
an increased adverse outcome in both the fetus and
the mother [1] . The incidence of prolonged pregnancy is
estimated as 4 - 19% at 42 weeks gestation and 2 - 7%
at 43 weeks of gestation [2] .
The prevalence of post-term pregnancy depends on
the population characteristics including such factors as
nulliparity, a prior post-term pregnancy and genetic
predisposition. The main complications associated
with pregnancy beyond 40 and 41 weeks of gestation
are stillbirth, perinatal mortality and morbidity and
increased risk of cesarean delivery [3] .
Obesity, maternal age 30 - 39 years and 40 years or
older are others risk factor of prolonged pregnancy [4] .
As pregnancy progresses beyond 40 weeks
of gestation, the risks of maternal peripartum
complications increase [5] and the rates of cesarean
delivery increase with increase of gestational age [6,7] .
Labor induction, prolonged second stage of labor,
forceps use and operative delivery are other maternal
complications of prolonged pregnancy beyond 41
weeks [8] . In this study, the prevalence rate of cesarean
delivery and the indications for cesarean in prolonged
pregnancy were evaluated.
SUBJECTS AND METHODS
A prospective descriptive cross-sectional study
was carried out on all prolonged pregnancy cases
encountered in the Semnan University Hospital Amir,
Semnan, Iran from September 2009 to September
2010.
Address correspondence to:
Sanam Moradan, MD, Associate Professor, Department of Obstetrics and Gynecology, Semnan University Hospital Amir, Semnan, Iran.
Mobile: 00989121318046, Fax: 00982314461580, E-mail: sm42595@yahoo.com