Clinical Trial of Induction of Labor Versus Expectant Management in Prolonged Pregnancy

Abstract

The objective of this study is to compare two strategies for managing prolonged pregnancy either by immediate induction
of labor at 41 weeks or expectant management until 43 weeks gestation. The study was conducted in Tripoli Medical
Center (TMC) for 12 months from beginning of January 2008 to end of December 2008. 300 pregnant women after 41
weeks gestation with singleton fetus in cephalic presentation and low risk pregnancy were enrolled for the studies.
The patients in this study were selected from out-patient department (OPD) and labor ward taking the information from
OPD charts.
Groups were managed expectantly depending on ante-partum fetal testing by using the following tests:
- Daily kick chart.
- Ultra sound twice weekly to measure amniotic fluid.
- Biophysical profile once weekly.
- Doppler ultra sound in some cases.
The perinatal outcome and the mode of delivery were insignificantly different in patients who were managed by induction
of labor at 41 weeks gestation or expectantly up to 42 weeks gestation.
In patients managed by expected management until 43 weeks gestation the perinatal mortality and morbidity increased
significantly (about three times more than 41 weeks or 42 weeks gestation).