| Research background:The gestational age more than40weeks is referred to extended pregnancy if pregnant women with normal menstrual cycle.Postterm pregnancy is defined as pregnancy that has reached42weeks.Postterm pregnancy lead to adverse maternal and neonatal outcomes has attracted the attention of all obstetricians. In recent years, someone have also defined pregnancy between41weeks and42weeks as prolonged pregnancy. Prolonged pregnancy is the transition of full-term pregnancy to postterm pregnancy,whether the negative factors of maternal and neonatal outcomes is gradually increasing with the extension of pregnancy days, when the induction should be done,the obstetricians have been researched these question.Research Objective:This article uses the case-control study, retrospectively compares and analysis the pregnant outcome of different gestational age those women who were over37gestational weeks, to explore the impact of prolonged pregnancy on maternal, fetal and neonatal, improve everyone’s attention.Methods:A retrospective study, including2006normal women who had delivered at the maternity hospital in the Shandong Provincial Obstetrics and Gynecology Hospital between January1,2010to December31,2011was conducted. The cases was Divided into four groups according to gestational age.The rate of operative vaginal delivery,cesarean delivery,fetal distress,neonatal asphyxia,meconium-stained amniotic fluid and admission to the neonatal intensive care unit were compared between the prolonged pregnancy group and the others.. Results:1. The vacuum extraction to help give birth rate of group Ⅰ,Ⅱ,Ⅲ,Ⅳ(37weeks <gestational age<40weeks;40weeks<gestational age<41weeks;41weeks<gestational age<42weeks; gestational age>42weeks) respectively was:1.58%,3.04%,4.33%,4.88%. The cesarean section rate was7.88%,12.16%,17.75%,24.39%. We can seen differences from mode of delivery on four groups:The rate of vacuum extraction delivery and cesarean delivery of group III were significantly increased than those of the group II and I, and the differences were statistically significant (P<0.05).2. The meconium-stained amniotic fluid rate of group Ⅰ,Ⅱ,Ⅲ,Ⅳ respectively was:9.98%,18.58%,19.05%,24.39%.The rate of meconium-stained amniotic fluid in prolonged pregnancy group was significantly increased than group I (P<0.05),but the differences between41-41+6gestational weeks and40+1～40+6gestational weeks was not statistically significant.3. The fetal distress rate of group Ⅰ,Ⅱ,Ⅲ,Ⅳ follows:7.53%,11.15%,19.05%,24.39%.The fetal distress rate of group III significantly increased than group I and II.The difference was statistically significant (P<0.05).4.The rate of neonatal asphyxia group Ⅰ and Ⅱ,Ⅲ,Ⅳ was as follows:1.58%,2.20%,4.05%,4.88%. The rate of neonatal asphyxia of group Ⅲ significantly increased than group I,. The difference was statistically significant (P<0.05).5. The rate of admission to the neonatal intensive care unit group I and II, III, IV was:3.42%,6.42%,6.93%,7.32%. The difference between group I and group II was statistically significant (P<0.05). all the other difference was not statistically significant (P>0.05).6. The newborn average birth weight increased with the gestational age increased, the incidence of macrosomia rates increases with the gestational age increased. macrosomia rates of group Ⅰ-Ⅳ respectively were:4%,6%,7%,10%,.7.The rate of instrumental delivery, cesarean delivery, fetal distress and neonatal asphyxia in group III were significantly increased than that of group I (P<0.05).Conclusion: 1.More than half pregnant women labored in37～40gestation week.2.An intensive antenatal surveillance involving a nonstress test and an evaluation of amniotic fluid volume should be given when gestation age was over40gestational week.3.Deliveries starting spontaneously41～41+6gestational weeks showed an increase in maternal and fetal complications:instrumental delivery,cesarean delivery,fetal distress and neonatal asphyxia, we should induction if the pregnant women have not labored. |
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