Definition and Clinical Features pregnancy beyond 42 weeks (10% of pregnancies) accurate dating essential etiology unknown morbi...
Definition and Clinical Features
- pregnancy beyond 42 weeks (10% of pregnancies)
- accurate dating essential
- etiology unknown
- morbidity increased with hypertension/PET, DM, abruption, IUGR and multiple gestation
Complications
- perinatal mortality 2-3 x higher
- oligohydramnios
- meconium passage; risk of meconium aspiration
- asphyxia
- macrosomia placental insufficiency; infarction of aging placenta
- postmaturity syndrome: 10-20% of post-term pregnancies (fetal weight loss, reduction in subcutaneous fat, scaling, dry skin from placental insufficiency)
- fetal movement count by the mother
- BPP twice weekly from 40 weeks
- delivery after 41 weeks if not already in labour since perinatal mortality is higher secondary to progressive uteroplacental insufficiency
- if BPP < 10/10 at any time, deliver
- decreased tolerance for asphyxia during intrapartum
