POSTTERM PREGNANCY: EXPECTANT MANAGEMENT AND INDUCTION OF LABOR

Objective: To study obstetric complications and perinatal outcomes in case of induction of labor at 41 weeks with expectant management until 42 weeks in low-risk women. Design: retrospective cohort study. 186 low risk women with an uncomplicated singleton pregnancy were chosen for the research in Republican Specialized Scientific and practical medical center for maternal and child health, branch of Fergana region: for main group (induction, n=94) and for control group (expectant management until 42 weeks, n=92). Results: Median gestational age at delivery was 41 weeks+1 days (range 41 weeks and 0 days - 41 weeks and 2 days) for the main group and 41 weeks+4 days (41 weeks and 2 days - 42 weeks and 0 days) for the control group. The perinatal outcomes were analysed for both main and control groups. The amount of pregnant women who had an adverse perinatal outcomes was 2/94 (2.1%) while 3/92 (3.3%) of females in the expectant management group had these complications (absolute risk difference −1.2%, 95% confidence interval −2.7% to 0.0%, P=0.21 for non-inferiority). 1 (1.1%) infants in the main group and 2 (2.2%) in the control group had an Apgar score <7 at five minutes (relative risk (RR) 0.5, 95% CI 0.23 to 0.98). Conclusions: this study shows inferiority of expectant management compared with induction of labor in low-risk pregnant women at 41 weeks; subsequently adverse perinatal outcomes were 1.2% higher in expectant management group, although both methods resulted in high level of good perinatal outcome and the absence of perinatal mortality, low rate of Apgar score less than four at five minutes, and neonatal intensive care admission.