Post-term Pregnancy

Post-term pregnancy

It happens that the due date has already passed, but the pregnancy is still ongoing - 10 days, two weeks... Then doctors talk about post-term pregnancy. It can be imaginary (chronological) and true (biological). In the first case, pregnancy is considered not to be post-term, but prolonged. The child is born full term without signs of overmaturity. True post-maturity is not so harmless. If the baby is retained in the uterus, the placenta, due to structural changes, is no longer able to provide it with the required amount of oxygen and nutrients, and chronic hypoxia is very harmful for the baby. In addition, for a child who is too large and weak, childbirth becomes a difficult ordeal. And therefore there is no need to delay with them.

Diagnosing a post-term pregnancy can be difficult, since post-term pregnancy usually does not have pronounced manifestations. A doctor observing a pregnant woman may notice a cessation of weight gain or a decrease, or a decrease in abdominal circumference. These symptoms are often associated with a decrease in the amount of amniotic fluid. In post-term pregnancy, there is often an increase or decrease in fetal movements, which indicates a lack of oxygen due to poor circulation in the uterus and placenta. The mammary glands may begin to secrete milk rather than colostrum. Postmaturity is also indicated by the presence of an immature cervix at a gestational age exceeding 40 weeks. The large weight of the fetus is not of decisive importance in diagnosis, since the birth of post-term babies of different weights is possible, although there is some tendency towards the birth of large children.

At 41 weeks, the expectant mother is hospitalized in the maternity hospital, where additional tests will be carried out. With the help of amnioscopy (visual examination of the fetal bladder) during post-term pregnancy, you can evaluate the color and transparency of the amniotic fluid, the number of flakes of cheese-like lubricant. Ultrasound examination will reveal oligohydramnios, thickening of the fetal skull bones and changes in the placenta. Amniocentesis (puncture of the amniotic sac and sampling of water) with subsequent biochemical examination of amniotic fluid helps in the diagnosis. Sometimes an oxytocin test is performed. A monitor sensor placed on the expectant mother's belly assesses the baby's heartbeat during uterine contractions, which are artificially induced using oxytocin administered intravenously.

If postterm pregnancy is confirmed, labor stimulation begins. Before this, the cervix must be prepared for childbirth.

When is there a reason to think? Practice shows that women most often carry their pregnancy to term:

1. with endocrine disorders (thyroid disorders, diabetes mellitus);
2. survivors of abortion and inflammatory diseases of the pelvic organs;
3. with an irregular menstrual cycle;
4. those suffering from diseases of the liver, stomach and intestines (the processes of estrogen metabolism are disrupted);
5. those who are on bed rest or lead a sedentary lifestyle (in this case, the fetal head does not descend into the pelvis and does not irritate the receptors of the cervix);
6. experiencing strong emotional stress.

Risk factors also include late gestosis, breech presentation of the fetus, post-term pregnancy, age of the first-time mother over 30 years, etc.

Post-term pregnancies began to be actively studied in 1902, and obstetricians have devoted more than a century to methods of preventing the threat of miscarriage. Consequently, considerable experience has been accumulated in solving such problems. Add to this the achievements of modern medicine, which were impossible to imagine 10–15 years ago, and you will understand that today doctors have turned almost into wizards, capable of performing real miracles. In difficult situations, only one thing is required of mothers - trust in the doctor. After all, a miracle is impossible without faith in it.