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Post term pregnancy

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Post term pregnancy

  1. 1. Post-term Pregnancy<br />www.freelivedoctor.com<br />
  2. 2. Definition<br />A pregnancy that persists for 42 weeks or more from the onset of the last menstrual period. Sometimes called postmaturity or postdate.<br />Incidence<br />5-10%. It is more common in primigravidae.<br />www.freelivedoctor.com<br />
  3. 3. Aetiology<br />Unknown, but hereditary, hormonal and non-engagement of the presenting part are suspected factors.<br />www.freelivedoctor.com<br />
  4. 4. Risk of Post-term<br />A. Placental insufficiency: which may lead to foetal hypoxia or even death.<br />B.Oligohydramnios: with its sequelae particularly cord compression during labour.<br />C. Obstructed labour: due to;<br /> * oversized baby,<br /> * no moulding of the skull due to more calcification.<br />D. Increased incidence of operative delivery.<br />www.freelivedoctor.com<br />
  5. 5. Diagnosis<br />Antenatal<br />> History: calculation of gestational age (see later).<br /> > Examination: larger baby size.<br /> > X-ray: large ossification center in the upper end of the tibia.<br />> Ultrasonography: can detect,<br />Biparietal diameter more than 9.6 cm.<br /> Increased foetal weight.<br />Oligohydramnios.<br /> Increased placental calcification.<br />>Tests for placental function.<br />www.freelivedoctor.com<br />
  6. 6. Diagnosis<br />Postnatal<br />a. Baby length: more than 54 cm.<br />b. Baby weight: more than 4.5 kg.<br />c. Skull: well ossified with smaller fontanelles.<br />d. Finger nails: project beyond finger tips.<br />www.freelivedoctor.com<br />
  7. 7. Management<br />Termination of labour is indicated which may be by:<br /> Induction of labour if the condition is favourable for vaginal delivery using:<br /> > amniotomy ± oxytocin, or<br /> > prostaglandins ± oxytocin.<br />Caesarean section: if conditions are not favourable for vaginal delivery, or if induction of labour failed.<br />www.freelivedoctor.com<br />