3 - post-term pregnancy

1. Epidemiology
1. True Prevalence of post-dates pregnancy: 2-3%
2. Pseudoprevalence (misdated pregnancy): 10-14%
2. Definition
1. Post-Term
1. Over 294 days (42 weeks) beyond first day of LMP
2. Post-Mature Infant
1. Truly post-term by objective criteria
3. Signs: Physical Characteristics of a post-dates infant
1. Underweight due to loss of subcutaneous fat
2. Long and thin in girth
3. Skin with patchy areas of Desquamation
4. Skin, long nails may be covered with meconium
5. Wrinkled hands and feet on ventral surfaces
4. Management: Antenatal Monitoring
1. Weekly Biophysical Profile
2. Amniotic Fluid Index
1. Demonstrate single 3 cm vertical fluid pocket
2. Lack of pocket associated with fetal asphyxia
3. Lack of pocket associated with perinatal mortality
3. Fetal heart monitoring
1. Biweekly Nonstress Test or
2. Weekly Contraction Stress Test
5. Management: Induction at 42 weeks
1. Induction at 41 weeks no recommended
1. No benefit to infant
2. Higher risk of labor complications
2. References
1. Alexander (2000) Obstet Gynecol 96:291