[Comparison of the risk of fetal hypoxia in active and expectant management of post-term delivery].

OBJECTIVE

Evaluation and comparison of risk of intrapartum foetal hypoxia in expectative and active approach after term of delivery.

DESIGN

Retrospective analysis.

SETTING

Gynaecological and Obstetric Clinic Medical Faculty, Masaryk University Brno.

METHODS

The authors compared retrospectively two groups. Group A comprised 1906 deliveries in 1996, group B 2008 deliveries in 1999. In group A 194 deliveries after the 41st week term was applied. In group B there were 373 deliveries with an expectative approach, with inductions after the 42nd week of pregnancy. The authors evaluated the number of surgical and induced deliveries in after-term pregnancy in both groups and analyzed in indications. The post-delivery condition of neonates was evaluated in both groups according to the Apgar score during the 1st, 5th and 10th minute, In group B the authors had for the blood from the umbilical artery. The condition of neonates delivered by a surgical approach in group B was made more accurate by the base excess (BE) blood from the umbilical artery. The statistical significance of results was evaluated by the U-test and chi 2 test.

RESULTS

The differences in the condition of neonates after delivery between the two groups are insignificant. In the expectative approach in 1999 there was a significant decline of the total number of induced deliveries and the total number of surgical deliveries. The difference in the number of surgical deliveries on account of imminent foetal hypoxia in group A and B are statistically insignificant. The number of hypoxic neonates is the same in both groups.

CONCLUSION

Based on the results of comparison of the two groups it is obvious that the expectative approach is safe and medically justified. It is not associated with a greater risk of intrauterine foetal hypoxia. It does not lead to deterioration of perinatal results and leads to a marked reduction of induced deliveries.