L5: Prolonged Pregnancy Flashcards
Def of Postdate Pregnancy
Pregnancy beyond EDD but not > completed 42 weeks
Def of Post-term Pregnancy
GA > completed 42 weeks (> 294 days)
Def of Postmature
Clinical syndrome that describes infant with clinical features indicating pathologically prolonged pregnancy
Incidence of Prolonged Pregnancy
Post-term pregnancy occurs in 7% of pregnancies
Etiology of Prolonged Pregnancy
Etiology of Prolonged Pregnancy
- Maternal
- Miscalculation: Commonest cause.
- Familial & Genetic factors.
- Poor nutrition.
Etiology of Prolonged Pregnancy
- Fetal & Placental
Complications of Prolonged Pregnancy
Dx of Prolonged Pregnancy
Dx of Prolonged Pregnancy
- during Pregnancy
Dx of Prolonged Pregnancy
- After Delivery
Managment of Prolonged Pregnancy
Managment of Prolonged Pregnancy
- Expectant Treatment
- Wait for spontaneous onset of labor (occurs in 60% at 40-41 weeks & in 80% by 43 weeks)
- Careful observation of fetal wellbeing (perform NST, CST & BPP twice weekly while waiting for spontaneous onset of labor).
Managment of Prolonged Pregnancy
- Active Managment (TOP)
Active TOP in Prolonged Pregnancy
- Indication
1) Pregnancy > 42 weeks.
2) Fetus is at risk (evidence of placental insufficiency by NST, CST & BPP).
Active TOP in Prolonged Pregnancy
- Methods
Active TOP in Prolonged Pregnancy
- Vaginal
Active TOP in Prolonged Pregnancy
- CS
If there is fetal distress, failed induction, other indication for CS.
Neonatal Care in Prolonged Pregnancy
Examination for congenital anomalies & treatment of complications
Def of Post-Maturity Syndrome
Postterm fetus with evidence of placental insufficiency
Incidence of Post-Maturity Syndrome
- 10% in pregnancies at 41-43 weeks
- 33% of pregnancies at 44 weeks.
Etiology of Post-Maturity Syndrome
Fetus outgrows its placental supply &/or placental functions deteriorate (placental aging)
Dx of Post-Maturity Syndrome
Dx of Post-Maturity Syndrome
- During Pregnancy
Dx of Post-Maturity Syndrome
- After Delivery
