Postterm pregnancy

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Multifocal/accomodating IOLs for monocular patients

The guidelines appeared in the September issue of Obstetrics and Gynecology. Post-term pregnancy is defined as a pregnancy that has extended to or beyond 42 weeks of gestation days, or estimated date of delivery [EDD] plus 14 days. The reported frequency of post-term pregnancy is approximately 7 percent.

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The American College of Obstetricians and Gynecologists

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The ideal time for delivery in low risk pregnancies has been debated since very long. ACOG efforts to stop elective induction before 39 weeks in well dated pregnancies have decreased neonatal morbidity and mortality. If recommendation say no elective induction before 39 weeks, why not induce every well dated patient at 39 weeks?

The debaters were Dr. Interestingly both the debaters agreed that continuing pregnancy beyond 39 weeks is risky for the fetus. In addition, risks to the mother associated with routine induction “are lower than appreciated. Lockwood also seconded the opinion saying “I was absolutely opposed” to the elective induction of labor at 39 weeks but after much reading it’s overwhelmingly evident that elective induction of labor is the logical strategy.

A11 late stillbirths pregnancies 28 weeks or later occur twice a common as deaths due to congenital anomalies; twice as common as deaths due to preterm complications, and ten times more common that Sudden Infant Deaths. Another retrospective study of , notified births published in BJOG , evaluated gestation-specific risks of stillbirth, neonatal and post-neonatal mortality. The study concluded that with each passing week the risk of still births and neonatal mortality increases by nearly 11 fold to that at 37weeks.

Multiple factors like the effects of parity, multiple pregnancy, congenital abnormality, meconium aspiration and uteroplacental insufficiency may be responsible for it but, requires further detailed analysis. Several other studies and meta-analysis have reiterated these findings. The major risk factor for induction at 39 weeks is failed induction leading to an operative intervention, but surprisingly both Dr.

Lockwood did not see any increased rate of cesarean delivery, albeit they found a decrease.


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