Maternal and Fetal Outcomes of Labour Induction at 39 vs 41 Weeks of Gestation

Abstract

Objective: To evaluate the maternal and fetal outcomes in elective induction of labour (IOL) at 39 weeks versus 41 weeks to suggest future guidelines for obstetric patients. The study compared the effects on mode of delivery (MOD), APGAR score, NICU admission and still birth rate.
Methodology: A Randomized controlled trial (RCT) and a single-center prospective study was conducted from October 2019 to July 2021 at Al-Nafees Medical College and Hospital, Islamabad. Low-risk primigravida (PG) and multigravida (MG) who delivered non-anomalous singletons fetus between 39 and 41 weeks after induction of labour (IOL) were included. To measure the maternal out come in view of MOD (vaginal or caesarean section) and fetal out comes (APGAR score at 5 minutes, NICU admission and still birth (SB) rate) were assessed.
Results: Two groups of 120 patients participated in the trial: group A (39 weeks) and group B (41 weeks), each group comprising of 60 patients. In group A, 85% of patients had a vaginal delivery, compared to 73% in Group B. Group A had a 15% CS rate while Group B had 27%. Group A had NICU admission rate of 3.3% while Group B had 12%. The two groups APGAR scores did not differ significantly, with APGAR > 7 being 95% in Group A and 97% in Group B
Conclusion: Elective IOL at 39 weeks does not increase caesarian rate, with no significance difference in APGAR score however NICU admission rate was higher in women delivered at 41 weeks of gestation.
Keywords: Induction of Labour, Fetal outcomes, Maternal outcome, postdate pregnancy.