How safely can post-term pregnancies with uncertain gestational age be followed up using amniotic fluid index measurements?
Objective. To review whether 2 weeks’ follow-up is safe for women at 42 weeks with an uncertain gestational age (GA) and amniotic fluid index (AFI) of ≥10 cm, as well as reassuring cardiotocography (CTG).
Methods. A retrospective descriptive study of women with an uncertain GA of 42 weeks was done at Tygerberg Hospital. The women had weekly CTG and AFI determinations. Induction of labour followed non-reassuring CTG or an AFI of <5.
Results. A total of 135 women were studied. The time interval between first evaluation at uncertain 42 weeks and delivery ranged between 0 and 46 days (median 10 days). Of the women, 104 had normal vaginal deliveries and 31 (23.0%) caesarean sections. Eleven women (8.1%) with an AFI ≥10 had CS for fetal distress within 2 weeks of the visit at 42 weeks. No neonatal morbidity or mortality was noted.
Conclusion. Weekly monitoring with CTG and AFI at 42 weeks with unsure GA is safe. A follow-up visit after 2 weeks cannot be recommended, as 8% of women required CS within less than 2 weeks because of fetal distress.
Amenah Mahmoud Mohamed, Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
Gerhard Barnard Theron, Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
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Date published: 2014-10-23
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