PREGNANCY DAYS For most pregnant women, carrying a baby to term is largely a mysterious process. This section helps new parents answer some of the most important questions about pregnancy and childbirth.

Post Datism

MATERNAL RISKS

After the fetus crosses the normal period of 280 days, there is some risk to the fetus and the mother. Maternal complications arise when the fetus continues to grow at the same rate as third trimester and there are complications like -

• Oligohydramnios
• Prolonged labor
• Dystocia
• Increased incidence of instrumentation or cesarean section
• Pelvis floor trauma because of large babies
• Increased risk of post partum hemorrhage (bleeding after the delivery
• Increased risk of endometriosis

Risks to the fetus

• Increased chances of still birth
• Fetal hypoxia and decreased blood supply to the fetus
• Meconeum aspiration
• Cord complications
• Peripheral nerve injuries
• Pneumonias
• Septicemia

CAN I PREVENT POST TERM PREGNANCY?

The best way to prevent it would be to do an early ultrasound to know the accurate due date. Some doctors also advocate sweeping of membranes from 38 weeks of pregnancy. This may cause problems like vaginal bleeding.

How will I be managed?

Before going for any kind of management, it will be imperative to first know what was the accurate due date.

If the patient has previous records, the ultrasound dating in the first trimester is the most reliable. (The error of ultrasound dating before 20 weeks of pregnancy gives the due date +/- 7 days).

Also the calculation of the due date with the last menstrual period is accurate, if the cycles have been accurate and you have not taken any oral contraceptive for a few months before the due date.

The measurement of the fundal height in the second trimester can also give a fairly good idea of the gestational age.

WHAT IS MOST IMPORTANT IS TO MANAGE EITHER BY INDUCING PREGNACY OR WAITING and this is a very subjective decision.

With time the risk of still births and decreased blood supply through the placenta increases and with judicious monitoring, one can decide upon the steps to be taken.

Studies have shown that the risk of still birth increased from 0.2 % at 37 weeks to 3.7 % at 42 weeks.

Fetal monitoring is done in the form of fetal kick counts, non stress tests and biophysical profile.

What is important is to take quick decision accurately to cause least harm to the mother and the fetus. It is better to be overcautious and early.