Post-term Pregnancy

Dr. Hazem Al-Mandeel

Post-term pregnancy

• Definition: is a pregnancy that persist beyond 42 weeks of gestation.

• Incidence ranges from 6-12%

• Perinatal (intrauterine or early neonatal) mortality by 2-3 times due to postmaturity/dysmaturity syndrome

• Dysmaturity syndrome occurs in 20-30% of postterm pregnancies. This leads to aging and infarction of the placenta causing insufficiency

• 70-80% of postterm fetuses may continue to grow leading to large size fetus (macrosomia> 4000gm). This leads to birth trauma, shoulder dystocia, abnormal labour and risk of caesarean sections

Management

• Accurate dating is essential for Dx• Antepartum: to identify fetuses with dysmaturity

syndrome by Ultrasonography and NST at 41 wks

If no concerns about fetal well-being continue close fetal monitoring till 42 weeks then induction of labour is indicated

• Intrapartum: continuous EFM during labour