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Postterm Pregnancy

OB/GYN

QuestionAnswer
what is prolonged or postterm pregnancy? pregnancy persisting beyond 42 weeks from onset of last menstrual cycle
incidence of postterm pregnancy? 6-12%
Why is perinatal mortality 2-3 times higher in prolonged gestation? Fetal post maturity syndrome. 20-30% growth restricted fetus in utero. placenta ages and infarcts>>insufficient o2/nutrient diffusion
Etiology of postterm pregnancy? unknown. -common association with anencephalic fetus -placental sulfatase deficiency -extrauterine pregnancy
Antepartum Management of postterm? if gestational age is definitely 42 weeks, fetal head is in pelvis, cervix favorable>>induce
Antepartum 42 weeks, unripe cervix? twice weekly NST and biophysical profile. wait for cervix to ripen deliver if AFI <5 or spontaneous fetal heart rate decelerations on NST
Antepartum uncertain gestational age? expectant approach
Intrapartum postterm management? continuous electronic fetal monitoring. -pt in left decubitus -rupture membranes early place internal electrodes and assess amnion fluid color C/S if fetal distress
Created by: asabi3 on 2012-04-23



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