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Postdatism And Postterm Pregnancy

Postdatism = pregnancy continuing beyond EDD or 40 weeks


Postterm = pregnancy continuing more than 42 weeks

  1. Etiology
    1. Idiopathic
    2. Past history
    3. Anencephaly
    4. Fetal adrenal hypoplasia
    5. X-linked placental sulfatase deficiency
  2. Complications
    1. Oligohydramnios
    2. MSAF
    3. Shoulder dystocia
    4. Sudden IUFD
    5. Uterine dysfunction
    6. Increased risk of operative delivery
    7. To confirm postdatism USE in first trimester (dating scan) is most useful.
Evaluation and Management of Postterm Pregnancy (ACOG Guidelines)
  1. Women with a postterm gestation who have an unfavorable cervix can either undergo labor induction or be managed expectantly.
  2. Prostaglandin can be used for cervical ripening and labor induction.
  3. Delivery should be effected if there is evidence of fetal compromise or oligohydramnios.
  4. It is reasonable to initiate antenatal surveillance between 40 and 42 weeks.
  5. A nons tress test (biweekly) and amniotic fluid volume assessment should be adequate.
  6. Many recommend prompt delivery in a woman with a postterm pregnancy, a favorable cervix, and no other complications.

NOTE: Normally the validity of NST is 7 days (i.e. if the NST is reactive it can be repeated after 7 days). But in cases of diabetes mellitus and postdatism the validity of NST is only 48 hours (it should be repeated every third day).

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