Prolonged pregnancy

Question 1

Define prolonged pregnancy

Answer 1

Pregnancy that exceeds 294 days (42 weeks) from the first day of the last menstrual period in a woman with
a regular 28-day cycle.

Question 2

Post-maturity sy of infants

Clinical features

Answer 2

• Stage I: Absence of vernix caseosa and lanugo (fine hair), loss of subcutaneous fat, and old looking.
• Stage II: Stage I + meconium staining of the amniotic fluid, and greenish nails and skin.
• Stage III: Stages I and II + dry, peeling and cracked skin, particularly on the hands and feet

Question 3

Stage I

Answer 3

Absence of vernix caseosa and lanugo (fine hair), loss of subcutaneous fat, and old looking

Question 4

Stage II

Answer 4

Stage I + meconium staining of the amniotic fluid, and greenish nails and skin

Question 5

Stage III

Answer 5

Stages I and II + dry, peeling and cracked skin, particularly on the hands and feet.

Question 6

Complications Prolonged pregnancy

Answer 6

Increased perinatal mortality .
- Intrapartum fetal distress and increased operative delivery rate.
- Meconium aspiration.

Question 7

Monitor prolonged pregnancy

Answer 7

Monitored by CTG, NST and amniotic fluid index (AFI) assessment between 40-41 weeks (normal 40 weeks
and preterm 37 weeks); those with low AFI are at increased risk of postmaturity sy.

§ Labour is managed by cervical preparation with prostaglandins or mechanical methods should be
attempted. If this fails then a caesarian is preferred.

Question 8

Predisposing factors prolonged pregnancy

Answer 8

Predisposing factors include hypo/aplasia of fetal pituitary and adrenal glands, absence of placental
sulfatase enzymes, cephalopelvic disproportion, and late term pregnancy in medical history.

§ All indicators of intrauterine malnutrition and often associated with oligohydramnios.