Postdatism And Postterm PregnancyPostdatism = pregnancy continuing beyond EDD or 40 weeks
Postterm = pregnancy continuing more than 42 weeks
- Past history
- Fetal adrenal hypoplasia
- X-linked placental sulfatase deficiency
- Shoulder dystocia
- Sudden IUFD
- Uterine dysfunction
- Increased risk of operative delivery
- To confirm postdatism USE in first trimester (dating scan) is most useful.
- Women with a postterm gestation who have an unfavorable cervix can either undergo labor induction or be managed expectantly.
- Prostaglandin can be used for cervical ripening and labor induction.
- Delivery should be effected if there is evidence of fetal compromise or oligohydramnios.
- It is reasonable to initiate antenatal surveillance between 40 and 42 weeks.
- A nons tress test (biweekly) and amniotic fluid volume assessment should be adequate.
- 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).