The Risks and Management

of Postterm Pregnancy
Postterm pregnancy is defined as a pregnancy that extends beyond 42 weeks of
gestation. This condition can lead to serious maternal and fetal complications,
including stillbirth. In this presentation, we will discuss the risks and management
of postterm pregnancy.
Maternal Risks
Maternal risks associated with postterm
pregnancy include an increased risk of
cesarean delivery, postpartum
hemorrhage, and infection. Additionally,
the mother may experience increased
anxiety and discomfort as the pregnancy
continues beyond the due date.
Fetal Risks
Fetal risks associated with postterm
pregnancy include an increased risk of
stillbirth, meconium aspiration syndrome,
and macrosomia. The risk of stillbirth
increases significantly after 42 weeks of
gestation.
Induction of Labor
Induction of labor is recommended for
postterm pregnancies to reduce the risk of
maternal and fetal complications. Methods
of induction include cervical ripening
agents, oxytocin, and mechanical methods
such as sweeping of the membranes.
Cervical ripening agents such as prostaglandins can be used to soften and dilate
the cervix prior to induction of labor. These agents can be administered either
vaginally or orally.
Oxytocin
Oxytocin is a hormone that stimulates
uterine contractions. It can be
administered intravenously to induce
labor or to augment labor that has already
begun.
Mechanical Methods
Mechanical methods of induction include
sweeping of the membranes and insertion
of a Foley catheter. Sweeping of the
membranes involves separating the
amniotic sac from the cervix, while a Foley
catheter is used to mechanically dilate the
cervix.
Monitoring During Labor

Continuous fetal monitoring is

recommended during labor to ensure the
safety of the mother and baby. This can be
done with electronic fetal monitoring or
with intermittent auscultation. Maternal
vital signs should also be monitored
regularly.
Delivery
Delivery is typically recommended for
postterm pregnancies by 42 weeks of
gestation. The method of delivery may
depend on factors such as fetal size and
position. Cesarean delivery may be
necessary if there are concerns about fetal
distress or if the mother is unable to
deliver vaginally.
Conclusion
Postterm pregnancy carries significant
risks for both the mother and baby.
Induction of labor is recommended to
reduce these risks. Close monitoring
during labor and delivery is necessary to
ensure the safety of both the mother and
baby.
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