Beyond 40 Weeks: A Comparative Study of Maternal and Neonatal Outcomes in Spontaneous vs Induced Labor

Introduction: Pregnancy extending beyond 40 weeks occurs in 2-14% of cases and poses risks to both mother and fetus. Mothers may experience higher rates of induced labor, instrumental deliveries, and cesarean sections with related complications. Fetuses are at risk for issues such as intrauterine growth restriction (IUGR) and macrosomia. Aim and Objective: To compare maternal and fetal outcome in spontaneous labor and induced labor beyond 40 weeks of gestation. Material and Methods: It was a hospital based prospective comparative study conducted in the Department of Obstetrics and Gynecology at Dr RPGMC Tanda at Kangra which were include 200 pregnant women who have crossed their expected date of delivery meeting the inclusion and exclusion criteria admitted to labor/obstetrics ward for delivery over a period of 1 year. Results: We found that Group 1 had a mean age of 27.6 years and Group 2 had 26.93 years. Misoprostol doses were higher in Group 1 (mean 2.90) than in Group 2 (2.34) with a significant difference (p = 0.001). Oxytocin use was similar across groups. Intrapartum and neonatal complications were comparable, with Group 2 having more hyperbilirubinemia (15%) and NICU admissions (8%). Maternal complications included similar rates of atonic PPH and surgical site infections in both groups, with higher traumatic PPH and gaped episiotomy in Group 1. Conclusion: Induction increased cesarean rates but did not raise maternal or neonatal complications. Spontaneous labor had better vaginal delivery rates. Individualized management is essential.