Background
The incidence of postterm pregnancy in the US as reported by the CDC's 2016 Vital Statistics Report.
What is 0.35%?
According to ACOG, the gestational age at which time expectant management is no longer acceptable
What is 42 weeks?
The nadir of perinatal mortality for singleton gestations occurs at this gestational age, with increasing risk with passage of each subsequent week thereafter.
What is 40 weeks?
What is a modified BPP?
The terms to describe the following gestational age ranges:
- 39 0/7 - 40 6/7
- 41 0/7 - 41 6/7
-37 0/7 - 38 6/7
-42 0/7 and beyond
What are full term pregnancy, late term pregnancy, early term pregnancy and postterm pregnancy?
In the setting of expectant management of late and postterm pregnancies, this should be initiated no later than 41 weeks.
What is antenatal testing?
In addition to macrosomia, this specific biometric parameter may be increased in postterm pregnancies.
What is fetal head circumference?
This syndrome is characterized by a reduction in abdominal fat, lack of lanugo and/or vernix.
What is postmaturity syndrome?
Risk factors for postterm pregnancy (4)
What are primigravidity, male fetus, obesity, prior history (personal or family)?
According to ACOG, all continuing pregnancies after 41 weeks should undergo this evaluation.
What is assessment of amniotic fluid volume?
Oligohydramnios has a high association with this other complication of postterm pregnancy, which occurs in 29% of these pregnancies.
What is meconium staining of amniotic fluid?
This complication of postterm pregnancy can result in abnormal surfactant production, reduced lung compliance, and chemical pneumonitis.
What is meconium aspiration syndrome?
1st trimester ultrasound is the optimal dating methodology due to this low margin of error in predicting gestational age.
What is 5 to 7 days?
The induction agents of choice in postterm pregnancy.
What are prostaglandins (Cytotec and Cervidil have equal efficacy)?
Postterm pregnancies, particularly those affected by macrosomia, are associated with increased rates of these MATERNAL complications (3).
What are cesarean delivery, perineal lacerations, and postpartum hemorrhage?
This fetal anomaly is associated postterm pregnancy, and is suspected to be the result of a failure to initiate the hormonal cascade of parturition.
What is anencephaly?
The placenta mediated components of the cascade of parturition.
What are an increase in prostaglandins and estrogens and a decrease in progesterone?
According to the 2018 Cochrane Review, this intervention can reduce the rate of postterm pregnancy with a NNT of 8.
What is membrane sweeping?
AFI <5cm is associated with these obstetric/neonatal outcomes (3)
What are intrapartum distress, pH < 7.0, and low APGAR scores?
Characterized by dry, scaly skin, this genetic disorder results in abnormalities in cholesterol production.
What is placental sulfatase deficiency
- OR -
X-linked ichthyosis