Prolonged Pregnancy

Question 1

Prolonged pregnancy

Answer 1

More than 42 weeks

Question 2

Post maturity is a sign of

Answer 2

Malnutrition

Question 3

Post maturity looks like

Answer 3

Infant covered with meconium, dry peeling skin, little vernix or lanugo hair, over grown nails, well developed palm and sole creases, abundant scalp hair, scaphoid abdomen, little subcutaneous fat, attentive apprehensive look

Question 4

Aetiology of prolonged labour

Answer 4

1- past obstetrical history
2- family history
3- more in white women
4- longer in summers
5- low fetal fibronectin levels at 39 weeks
6- low CRH levels
7- fetal ancephalopathy, congenital adrenal hyperplasia, placental sulphatase deficiency

Question 5

Significance of prolonged labour

Answer 5

1- fetal macrosomia
2- fetal hypoxia due to declining placental function
3- decrease in liquor volume
4- fetal parasympathetic system matures so meconium passage

Question 6

Fetal implications

Answer 6

Birth trauma and shoulder dystocia
Fetal death
Cord compression
Meconium aspiration

Question 7

Maternal implications

Answer 7

Anxiety
Inc risk of prolonged labour and instrumental delivery
Inc risk of c section

Question 8

Offer induction to following patients

Answer 8

1- fetal Macrosomia 
2- non reactive ctg 
3- reduced liquor volume 
4- poor biophysical profile/Doppler studies 
5- ripe cervix 
6- women requesting induction

Question 9

At what week should baby be delivered

Answer 9

43 weeks