1. POST MATURITY

3. DEFINITION
A pregnancy continuing beyond two weeks of the expected date of delivery is called postmaturity or post term pregnancy

4. INCIDENCE
2-10%

5. ETIOLOGY Hereditary High standard of living with sedentary habits
Anencephaly without polyhydramnios
Placental sulphate deficiency
Fetal adrenal hypoplasia
Elderly
primigravidae or elderly multiparae

6. DIAGNOSIS MENSTRUAL HISTORY THE SUSPECTED CLINICAL FINDING Weight loss
Girth of abdomen
History of false pain
Obstetrical palpation
Internal examination

7. INVESTIGATIONS TO CONFIRM FETAL MATURITY
SONOGRAPHY
CRL
BPD FL
AMNIOCENTESIS
Lecithin sphingomyelin ratio
STRAIGHT X RAY ABDOMEN
TO DETECT EVIDENCE OF PLACENTAL INSUFFICIENCY

8. CLINICAL PRESENTATION FOR THE DIAGNOSIS AFTER BIRTH
Baby
Weight and length of 4kg or more and 54cm
Looks thin and old
Absence of vernix caseosa
Body and cord are stained with greenish yellow colour
Head is hard without much evidence of moulding
Nails are protruding beyond nail bed
Liquor amnii
Scanty and saffron coloured with meconium
Placenta
Ageing – excessive infarction and calcification
Cord
Dimnished quantity of whartons jelly

9. DANGERS FETAL DURING PREGNANCY Fetal hypoxia DURING LABOUR Asphyxia
Intracranial damage
FOLLOWING BIRTH
Meconium aspiration syndrome and atelectasis
Low apgar score
Hypoglycemia and polycythemia
MATERNAL
Increased morbidity
Hazards of induction, instrumental and operative delivery

10. MANAGEMENT UNCOMPLICATED Selective induction Routine induction
Cervix ripe
Cervix unripe
COMPLICATED
LSCS

11. CARE DURING LABOUR Labour may porolonged Analgesia for pain releief
Careful fetal monitoring