1 / 11

POST-TERM PREGNANCY Dr.Mona Shroff (Dept. of O&G .SMIMER)

POST-TERM PREGNANCY Dr.Mona Shroff (Dept. of O&G .SMIMER). DEFINITION. POSTTERM: >42 completed weeks (>294d) POST DATE: >40 completed weeks(280d) POST MATURITY: Specific syndrome of infant associated with postterm preg. INCIDENCE. BY LMP : 7.5 % BY USG : 2.6 %

Download Presentation

POST-TERM PREGNANCY Dr.Mona Shroff (Dept. of O&G .SMIMER)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. POST-TERM PREGNANCYDr.Mona Shroff(Dept. of O&G .SMIMER)

  2. DEFINITION • POSTTERM: >42 completed weeks (>294d) • POST DATE: >40 completed weeks(280d) • POST MATURITY: Specific syndrome of infant associated with postterm preg

  3. INCIDENCE • BY LMP : 7.5 % • BY USG : 2.6 % • BY LMP + USG : 1.1 % • Previous 1 postterm : 27 % • Previous 2 postterm : 39 %

  4. AETIOLOGY • Wrong dates • Biological-previous prolonged preg. • Irregular ovulation • Decreased fetal estrogen production Placental sulfatase deficiency Anencephaly Fetal adrenal hypoplasia • Extrauterine preg (v. rare)

  5. PHYSILOGICAL CHANGES ASS. WITH POSTTERM GESTATION • PLACENTAL CHANGES : senescence/ageing (increased grading on usg) infarcts,calcification • AMNIOTIC FLUID CHANGES : Oligohydramnios (diminished fetal urination) cloudy (flakes of vernix) L/S ratio => 4:1 presence of meconium • FETAL CHANGES : 45%-Macrosomia 10%-IU malnutrition

  6. COMPLICATIONS MATERNAL • Anxiety • Traumatic vaginal delivery-shoulder dystocia • Increased CS rate • PPH risk FETAL • Fetal distress • MAS • Fetal trauma brachial plexus injuries, clavicle fracture • Increased perinatal mortality • Dysmaturity syndrome

  7. MANAGEMENT CONFIRMATION OF GESTATIONAL AGE 1. Reliable LMP Date known No OCP for 3 mnths Regular cycles 2. First trimester CRL(+/-7d) 3. Second trimester BPD (+/- 14d) 4. First trimester P/V examination 5. Doppler FHT 10 wks 6. Quickening 16-18 wks

  8. USG AFI <5 oligohydramnios Macrosomia Placental grading • P/V examination Assess inducibility-BISHOPS score

  9. INTRAPARTUM MANAGEMENT • Left lateral position • Continuous electronic fetal monitoring • Early ARM in active phase (hastens progress, detects meconium) • LSCS if CPD/macrosomia,fetal distress • Amnioinfusion (750-1000ml NS/RL) –If meconium stained liquor,variable deccelerations • Paediatrician called at delivery

  10. PREVENTION Sweeping/stripping of membranes at term if no vaginitis, malpresentation or placenta praevia

More Related