PLACENTAL INSUFFICIENCY IN PREGNANCY AFTER 40 th WEEK OF GESTATION

Pregnancy after the 40 week of gestation is often a great dilemma for obstetrician in diagnostic, therapeutic and in psychological terms as well. The aim of this study was to confirm the phenomenon of placental insufficiency in pregnancy after the 40 gestation week, the modality of delivery and perinatal outcome. The study comprised 3405 deliveries in a period of one year, 391 of which were terminated after the end of the 40 gestation week, including healthy pregnant women with singleton pregnancies. Control group included healthy pregnant women delivered between the 37 and 40 gestation week. The incidence of deliveries after the 40 week of gestation is 11.48%. Non-stress test was reactive in 99.65% of women in the study group. At the same time, CST (constriction – stress test) was assessed as negative in 78.67% of cases. The pathological CST was found in only 1.33% of cases. Doppler ultrasound measurements showed the increased resistance in umbilical artery flow in 3% of cases. Vacuum extraction was used for 16.62% of deliveries in the study group, and 8.73% of deliveries in the control group (χ=23.24; p<0.001). In the study group, Caesarean section was performed in 14.58% of cases, and in control group in 9.07% (χ=11.09; p<0.001). Placental insufficiency induced by duration of pregnancy is a rear phenomenon in uncompromised pregnancy. There was no significant difference in the morbidity and mortality rates between the study and control group. Acta Medica Medianae 2007; 46(4):26-30.