Post Term Pregnancy – What Are The Concerns?

Post Term Pregnancy – What Are The Concerns?

For a woman, spending those 9 months carrying a little life inside is no less than a daunting task. Some of the babies would complete their gestational stay on time, some unfortunate ones may be born prematurely but what happens if a child passes his due date of gestational stay? We will try to find out everything related to overdue or post-term pregnancies in this article.

Post-term pregnancy

While 9 months is a universal terminology, pregnancy is technically counted in number of weeks. Full-term babies are normally delivered somewhere between 37 and 42 weeks. The weeks are counted from the very first day of a woman’s last menstrual period. A pregnancy that reaches 42 weeks or more is known as post-term or post-date pregnancy. It is also called as overdue pregnancy or late-term pregnancy.

Babies born in various timeframes can be categorized into following:

  • Early term - 37 weeks to 38 weeks, 6 days
  • Full-term -  39 weeks to 40 weeks, 6 days
  • Late term - 41 weeks to 41 weeks, 6 days
  • Post-term - 42 weeks or more

How common is post-term pregnancy?

Overdue pregnancies are fairly common. As per American College of Obstetricians and Gynaecologists, about 10 percent of all pregnancies, go beyond 42 weeks. 

Reasons why many women deliver post date

Due dates can be extremely tricky to determine as it’s hard to exactly pinpoint the age of the fetus. So doctors can only offer the best possible estimates. The reasons for this can be irregular menstrual periods and inaccurate menstrual history told to the doctor. Sometimes mistaking for spotting (bleeding) during early pregnancy for a period can be a cause of overdue date.

Doctors typically guesstimate by taking following things into consideration:

  • Calculation derived from the last ovulation which is also considered the most trustworthy method
  • Evaluation based on the first day of the last menstrual period
  • Ultrasound which is done within 7-10 days
  • First detection of fetal movement (16-20 weeks)
  • Fetal heartbeat which can be detected as early as 18 weeks

Women who have irregular cycles can create more difficulties for the doctor to evaluate the due date. In short, there is no method known to medical science that can exactly determine the due date.
Factors that might increase chances of post-term pregnancy

Following pointers can indicate that you may deliver post-term:

  • First pregnancy
  • History of overdue pregnancy
  • Baby boy

What are the concerns linked to late-term pregnancy?

Most of the babies born post-term will be in good health. However, a small number of them are linked to stillbirth. This is the reason a pregnant woman is closely monitored after 40 weeks. But many doctors in order to avoid any risk deliver the baby before 42 weeks through induced labor. 

How common is induced labor in post-term pregnancy?

According to a study, the induced delivery rate is 12.1 percent in Asia while induction without medicine stands at 3.6 percent in India. About 32 percent induced labor in India are elective with varying rates depending on the location.

Complications related to post-term pregnancy

Recent studies have shown some risk of complications associated with post-term pregnancy. These include:

  • Chances of infection
  • High blood pressure in the mother
  • Low fluid
  • Increased use of forceps or vacuum assistance to extract the baby

Tests after post-term pregnancy

After around 41 weeks, the doctors and the midwife may use additional testing to ensure the well-being of both the mothers and the baby. These include:

  • Non-stress Test (NST)
  • Biophysical profile (BPP)
  • Vaginal examination to check if cervix is soft and stretchy

Depending on the results of these tests, the team of doctor will decide either to wait or go for induced labor.

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Delivery post-term

After the due date is crossed and if some fetal problem shows up in the testing, then it means it’s time to deliver the baby.

  • If after the vaginal examination, the doctors see that the cervix is well prepared for the delivery, they might speed up the process of induced labor. This would start in the clinic with a simple sweeping of membranes, also known as stretch and sweep. In this internal procedure, doctors will try to separate the membranes of amniotic sac from the cervix. This would help release hormone prostaglandins, which would help initiate labor.
  • If the cervix isn’t prepared for the delivery, wait and watch would be the reasonable first option. But on the other hand, giving medicine for induced labor does have some benefits. According to a study, if the cervix is softened for induced labor after 41 weeks, it can lower the rate of stillbirth as well as infant death.

Whichever option the doctors choose, the deaths are very rare. Make sure you follow the routine check-ups, the synchronization with the gynecologist will definitely put you on the safe side.