Prolonged pregnancy: a rational approach to management

ABSTRACT

The optimum management of prolonged pregnancy is controversial. Eighty-two patients with this problem were managed prospectively. If the cervix was favourable for induction of labour, this was done. If the cervix was unfavourable, pregnancy was allowed to continue but the foetus was monitored with twice weekly non-stressed cardiotocography. A control group of 115 patients who were all induced at 42-weeks gestation was used to compare pregnancy outcome. Selective intervention resulted in reducing the induction rate by half. Pregnancies managed conservatively resulted in fewer (6.6 percent as opposed to 30 percent) Caesarean births in the induced pregnancies. More babies with higher Apgar scores at birth were born to the conservatively managed patients (AU)