Prolonged Pregnancy PDF

Prolonged Pregnancy Dr. Samar Hassan Mohammed Ali MBBS MD MSc MHPE Assistant professor ob.gyn. AAU Learning Outcomes By the end of this session you should be able to: Define the postdate and post-term pregnancy Identify the fetal risks of post-term pregnancy Outline the managemen...

Prolonged Pregnancy Dr. Samar Hassan Mohammed Ali MBBS MD MSc MHPE Assistant professor ob.gyn. AAU Learning Outcomes By the end of this session you should be able to: Define the postdate and post-term pregnancy Identify the fetal risks of post-term pregnancy Outline the management of prolonged pregnancy Prolonged Pregnancy Definitions Post date pregnancy: is pregnancy which extends beyond 40 weeks gestation Post-term pregnancy: is pregnancy which extends to or beyond 42 weeks gestation. Prolonged Pregnancy 10% of pregnancies Accurate dating is essential to diagnose it (first trimester scan) Prolonged Pregnancy Risks of post term pregnancy The risk of still birth and neonatal death are increased by two folds after 42 weeks gestation Increased risk of macrosomia Increased risk of foetal distress in labour Increased risk of Meconium aspiration syndrome Increased risk of operative delivery Prolonged Pregnancy Management From 40 weeks gestation antenatal visit: Membrane sweeping is recommended to decrease the need for induction of labour. After 40 weeks gestation: It is essential to revise her LMP and early dating scan before making a diagnosis. Ask the patient about foetal movement and examine for foetal heart sound. Ultrasound for amount liquor which is an indicator of foetal well being. Prolonged Pregnancy Management (Cont.) If foetal well being is confirmed, and there is no indication for caesarean section, induction of labour is planned at 41 weeks +3 days. The patient should report to hospital at any time if there is reduced foetal movement N.B. If patients who are planned for VBAC passed their dates, will be candidates for caesarean section. Thank you