Late delivery
Late delivery:
The duration of pregnancy is normally 37 to 42 weeks and the average is 40 weeks (280 days) from the first day of the last menstrual period and when the duration is more than 42 weeks, it is called a prolonged pregnancy.
Its actual prevalence is about 3%. In about two-thirds of cases, gestational age is incorrectly estimated as a result of the pregnant mother’s mistake in remembering the date of the first day of her last menstrual period.
Cause of late pregnancy:
The real cause is unknown. Some known causes are:
• Error in the date of the last menstrual period
Fetal brain developmental defect
Women of the first abdomen and older gestational age
• Some races (Australian, Italian and Greek)
• A history of prolonged pregnancy in a previous pregnancy
Complications of a prolonged pregnancy:
Increased risk of fetal and maternal death after 42 weeks of gestation, anxiety and worry of pregnant mother, continued fetal growth and delivery It feeds the fetus and reduces its oxygen supply and growth retardation, dehydration of the amniotic sac, and defecation due to unfavorable conditions inside the uterus, which can cause obstruction of the airways and death of the baby.
Fetal and maternal evaluation:
The usual method of determining the exact gestational age is based on the date of the first day of the last menstrual period. The most reliable method is based on determining the time of ovulation by determining the basal body temperature.
Ultrasound at 5 to 23 weeks is more suitable for determining gestational age, and after 26 weeks, its accuracy in estimating gestational age decreases.
Evaluation of fetal health by fetal ECG test: In this method, the fetal heart rate during its activity is monitored and recorded for 20 minutes.
If the fetal ECG is normal, 99% of cases can be assured of fetal health for up to 36 hours, provided that abnormal events such as placental abruption and ………. have not occurred. Ultrasound is used to assess and score respiratory status, heart rate, movements and the amount of water in the amniotic sac. The normal result of the ultrasound shows the health of the fetus in the next week.
The mother’s attention to reducing fetal movements and timely referral (less than 10 movements in 12 hours) is important.
Therapeutic measures:
Pregnancy is generally allowed to continue until 42 weeks when the mother and fetus are not at risk.
In cases such as high blood pressure, diabetes, kidney dysfunction and a history of previous cesarean section, continuation of pregnancy longer than 37 to 40 weeks is not allowed.
If the mother and fetus are in perfect health, the pregnancy should be terminated at 42 weeks, which is done by inducing labor and using the drug that causes labor pains, along with examining how the fetal heart beats during labor.