Definition , Incidence , Risk factors , Complications ,Fetal complications , Maternal complications , Management, Confirmation of gestational age , Determination of gestational age, Conservative treatment , Induction of labor

1. POST – TERM PREGNANCY
- DR.SUPRIYA MAHIND

2. POST – TERM PREGNANCY
• Any pregnancy that exceeds 42 weeks from the first day
of last menstrual period in women with regular 28 day
cycles
• Also known as postdate pregnancy and prolonged
pregnancy

3. INCIDENCE
• The generally quoted incidence of PT pregnancy
is 10%
• Incidence is decreasing because of better
estimation of duration of gestation and timely
induction of Labour

4. RISK FACTORS
• Past history of prolonged pregnancy
• Family history
• Anencephaly
• Extra uterine pregnancy

5. COMPLICATION
• FETAL COMPLICATION
• Macrosomia Syndrome
• Dysmaturity Syndrome
• MATERNAL COMPLICATION
• Anxiety
• Prolonged labour
• C - section

6. Fetal Complication
• Macrosomia syndrome
Occurs when placental function is maintained (80% cases)
Results in healthy but large fetus
Amniotic fluid is normal
Increase risk of C-SECTION because of prolonged and arrested
labour
Shoulder dystocia

7. Dysmaturity syndrome
• When placental function deteriorates (20%)
• Placental insufficiency results in reduction of metabollic
and respiratory support to fetus
• Amniotic fluid is decreased
• Increases risk of C – section because of non reassuring
fetal heart rate patterns
• Oligohydramnios results in umbilical cord compression

8. MATERNAL COMPLICATIONS
• Anxiety
Is commonly seen postdate pregnancy because of worry of increase in
gestation period from the EDD
• Prolonged labour
Chances increases significantly and also the risk of instrumental
delivery
• C – section
Risk of C – section is also greatly increased

9. MANAGEMENT
• It depends on the
 Confirmation of gestational age
Favourability of cervix

10. CONFIRMATION OF GESTATIONALAGE
• In a booked case confirmation of gestational age is easily
determined
• In an unbooked case , diagnosis of post term pregnancy
poses a major challenge .

11. DETERMINATION OF GESTATIONAL AGE
• HISTORY
LMP
EARLY U/S
FAMILY HISTORY
History of Neural tube defects
• EXAMINATION
• SFH
• BISHOP SCORING

12. INVESTIGATIONS
• U/S
• NST
• AFI
After confirmation of gestational age management plan
is decided

13. CONSERVATIVE MANAGEMENT
• 50% women going beyond 42 weeks of gestation
experience spontaneous labour in 4-5 days
• Poor bishop score
• Good Fetal Health + Adequate Placental function

14. INDUCTION OF LABOUR
1) Favourable cervix
2) Oligohydramnios
3) Fetal macrosomia
4) Non reactive NST

15. THANKS