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15 Postmaturity 1

15_POSTMATURITY_1

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33 views2 pages

15 Postmaturity 1

15_POSTMATURITY_1

Uploaded by

Bright Kumwenda
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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POSTMATURITY

By Laston Kastom BscBMS(RH),Dip.Clin.Med

INTRODUCTION

It is also known as post-term pregnancy. It applies to unduly prolonged pregnancy, commonly


considered to be 294 days from the day of the last menstrual period, and this is equivalent to 42 weeks.
Term pregnancy by definition is 37-42 weeks, and a very small proportion of about 5% of pregnancies
would proceed beyond 42 weeks if left alone. It should be clear here that the definition of post maturity
for a woman depends on her accurate dates. Post maturity is a common indication for induction of
labour, mainly because of fears about fetal anoxia.

PATHOLOGY IN POSTMATURITY

The fetus is at its maximum size, and the placenta is becoming more calcified, less efficient and more
prone to failure. So because of insufficient placenta the baby may be anoxia hence distressed, and may
die.

CAUSES

The causes of post maturity are still obsque.

DIAGNOSIS

You should begin by checking that the date of delivery was calculated correctly.

There are four criteria for the diagnosis of the true postmaturity

1 .The date of the last menstrual period must be certain

2 .There is no history of conditions known to be associated with delayed ovulation like;

 Irregular menstrual cycles

 Use of the pills up to the last menstrual period

 Breast feeding

3 .The patient attended antenatal clinic before 28 weeks and the fundal height was appropriate for
dates.

4 .The gestational age on ultrasound scanning is also showing the post term age.

MANAGEMENT

1.Doubtful postmaturity

This when you are not sure of the dates or the diagnosis.
 You need to reassure the patient

 And await for the spontaneous onset of labour.

2.True post maturity

The management may depend on whether the patient has risk factors and also advance in the age of the
pregnancy.

If the patient has no risk factors;

In here you have options, you may await spontaneous labour or you may induce the labour after
consultations.

If the patient has risk factors;

These factors include old primigravidity, old multiparity, bad obstetrical history, hypertensive disorders,
oligohydramnious, fetal distress.

In this situations you need to admit the patient, and decide the mode of delivery. The preferred way is
to do bishop score and if it is favourable perform induction, if induction has failed or it is impossible then
you may do caesarean section.

COMPLICATIONS OF POSTMATURITY

 Intrauterine Death

 Fetal distress

 Cephalopelvic disproportion ( due to larger, harder and less mouldable head )

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