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