Items in AFP with MESH term: Pregnancy, Prolonged
ABSTRACT: A post-term or prolonged pregnancy is one that reaches 42 weeks' gestation; approximately 5 to 10 percent of pregnancies are post-term. Studies have shown a reduction in the number of pregnancies considered post-term when early ultrasound dating is performed. Maternal and fetal risks increase with gestational age, but the management of otherwise low-risk prolonged pregnancies is controversial. Antenatal surveillance with fetal kick counts, nonstress testing, amniotic fluid index measurement, and biophysical profiles is used, although no data show that monitoring improves outcomes. Studies show a reduction in the rate of cesarean deliveries and possibly in neonatal mortality with a policy of routine labor induction at 41 weeks' gestation.
Induction of Labor at or Beyond Term - Cochrane for Clinicians
ACOG Issues Report on the Management of Post-term Pregnancy - Special Medical Reports
ABSTRACT: Pregnancy is considered late term from 41 weeks, 0 days’ to 41 weeks, 6 days’ gestation, and postterm at 42 weeks’ gestation. Early dating of the pregnancy is important for accurately determining when a pregnancy is late- or postterm, and first-trimester ultrasonography should be performed if clinical dating is uncertain. Optimal management of a low-risk, late-term pregnancy should consider maternal preference and balance the benefits and risks of induction vs. waiting for spontaneous labor. Compared with expectant management, induction at 41 weeks’ gestation is associated with a small absolute decrease in perinatal mortality and decreases in other fetal and maternal risks without an increased risk of cesarean delivery. Although there is no clear evidence that antenatal testing beginning at 41 weeks’ gestation prevents intrauterine fetal demise, it is often performed because the risks are low. When expectant management is chosen, most experts recommend beginning twice-weekly antenatal surveillance at 41 weeks with biophysical profile or nonstress testing plus amniotic fluid index (modified biophysical profile); induction may be deferred until 42 weeks if this surveillance is reassuring.