FETAL OUTCOME OF INDUCTION OF LABOUR AT TERM VERSUS EXPECTANT MANAGEMENT FOR ELDERLY NULLIPAROUS MOTHERS

Background and Objective: Maternal age is an important determinant of pregnancy outcome. The women of age 35 years or more undergoing there first pregnancy are often classified as high risk obstetrics patients. Induction of labor and expectant management is a serious challenge in these patients. The objective of the study was to determine the perinatal outcome of elective induction with expectant management in elderly nulliparous women ≥35 years of age at term (≥ 39 weeks of gestation) Methods: In this study, 222 mothers of age ≥ 35 years were enrolled from the Obstetrical Department Lady Willingdon Hospital after informed consent. Randomization was done by convenient sampling into two groups 111 patients in each. In Group-A induction of labor and in Group-B expectant management was done. Data was analyzed by SPSS version 22. Results: In this study mean age in induction (Group-A) was 37.30 ± 2.27 years and in expectant management (Group-B) was 37.40 ± 2.28 years. There were 55 (49.5%) obese and 56 (50.5%) non-obese and in group-B (expectant group) there were 44 (39.6%) obese and 67 (60.4%) non- obese female (p-value 0.05). In group-A there were 5 (4.5%) and in group-B 13 (11.7%) perinatal mortalities were observed (p-value 0.049). There were 4 (3.6%) still births in group-A and 6 (5.4%) in group-B, (p-value 0.518). Neonatal deaths were significantly higher in group-B (6.3%) when compared to group-A (0.9%), p-value 0.031. Conclusion: Expectant management had higher perinatal mortality as compared to induction of labour in elderly nulliparous women at term.