Management of prolonged pregnancy: Results of a prospective randomized trial

Prolonged pregnancy was rigorously defined in 180 gravid women without other complications. Patients were randomly assigned to be serially followed either by amniocentesis or by oxytocin challenge teats (OCT’s). Induction of labor, based upon Only (1) a finding of meconium in the amniocentesis group or (2) a Positive test in the OCT group, was nearly three times more frequent in the amniocentesis group. The incidence of meconium, which overall was 22% initially and 44% at delivery, as welt as ihe ·frequencies of obstetric and perinatal complications, were similar in both management groups. Although meconium was Significantly associated with abnormal labor progression, intrapartum fetal distress, and low 1 and 5 minute Apgar acores, induction of labor after discovery of meconium, when compered to nonintervention did not improve perinatal outcome. It is concluded that a search for meconiunm is of little value in the management of prolonged pregnancy.