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Flashcards in Post Term Pregnancy Deck (12):
1

What is post-term pregnancy?

Gestation more than 42+0

2

Which women are at highest risk of post term pregnancy?

Previous post term pregnancy (risk increases x2 - x4)

3

What are the modest RFx for post term pregnancy?

- Nulliparity
- Male foetus
- Obesity
- Older MA
- Parents post term
- Cultural background

4

What are the foetal and neonatal complications of post term pregnancy?

- Macrosomia
- Dysmaturity
- Perinatal mortality

5

What are the complications of macrosomia?

- protracted or arrested labour
- Shoulder dystocia
i.e. increased risk of birth injury

6

What is dysmaturity?

Syndrome of chronic intrauterine malnutrition. Foetuses are:
- long, thin and small.
- Have long nails.
- skin is dry, peeling
- meconium stained

7

How does perinatal mortality change with postterm pregnancy?

At 42w+ perinatal mortality is twice the rate of at term.
- 43w = 4x
- 44w = 5-7x

8

What are the presumed aetiologies of perinatal mortality in post-term pregnancy?

- Infection
- Placental insufficiency
- Cord compression
- Asphyxia
- Meconium

9

What are the maternal complications of post term pregnancy?

Sequelae or IOL, macrosomia.
- Failed IOL
- 3rd/4th degree tears
- Infection
- PPH

10

What are the management options for otherwise normal foetus reaching 41+0?

- IOL (41 - 42+0)
- Expectant with foetal monitoring (usually twice weekly)

11

Why is expectant management still a reasonable option despite a potential increase in perinatal mortality?

- Low absolute foetal death rate post term
- hence relatively high number of inductions to prevent one post term FDIU

12

When is induction indicated in post term pregnancy?

- Obstetrical indications
- 42 +6