{"id":222,"date":"2020-08-13T16:28:56","date_gmt":"2020-08-13T16:28:56","guid":{"rendered":"https:\/\/brooksidepress.org\/basic_obgyn\/?page_id=222"},"modified":"2023-09-30T10:32:55","modified_gmt":"2023-09-30T10:32:55","slug":"30-postterm-pregnancy","status":"publish","type":"page","link":"https:\/\/brooksidepress.org\/basic_obgyn\/overview\/30-postterm-pregnancy\/","title":{"rendered":"30. Postterm Pregnancy"},"content":{"rendered":"<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/cRVuSpPlx0c\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>Duration = 3:41<\/p>\n<input type='hidden' bg_collapse_expand='69e9dc8db7e764077325669' value='69e9dc8db7e764077325669'><input type='hidden' id='bg-show-more-text-69e9dc8db7e764077325669' value='Show Transcript'><input type='hidden' id='bg-show-less-text-69e9dc8db7e764077325669' value='Hide Transcript'><button id='bg-showmore-action-69e9dc8db7e764077325669' class='bg-showmore-plg-button bg-blue-button  '   style=\" color:#ffffff;\">Show Transcript<\/button><div id='bg-showmore-hidden-69e9dc8db7e764077325669' ><\/p>\n<p>00:00<br \/>\nAPGO educational topic number 30 post<br \/>\n00:02<br \/>\nterm pregnancy post term pregnancy is<br \/>\n00:05<br \/>\ndefined as reaching or extending beyond<br \/>\n00:06<br \/>\n42 weeks estimated gestational age the<br \/>\n00:10<br \/>\nincidence of post term pregnancy in the<br \/>\n00:11<br \/>\nUnited States is 5.5 percent in this<br \/>\n00:14<br \/>\nvideo we will review how perinatal<br \/>\n00:15<br \/>\nmorbidity and mortality increase with a<br \/>\n00:17<br \/>\nprolonged pregnancy the objectives of<br \/>\n00:19<br \/>\nthis video are to identify the normal<br \/>\n00:21<br \/>\nduration of pregnancy list the<br \/>\n00:23<br \/>\ncomplications in prolonged gestation and<br \/>\n00:25<br \/>\ndescribe the evaluation and<br \/>\n00:27<br \/>\nevidence-based management options for<br \/>\n00:29<br \/>\nprolonged gestation remember that we<br \/>\n00:31<br \/>\ndate pregnancies using menstrual dating<br \/>\n00:33<br \/>\nthe estimated date of delivery is<br \/>\n00:34<br \/>\ncalculated as 40 weeks past the first<br \/>\n00:36<br \/>\nday of her last menstrual period late<br \/>\n00:39<br \/>\nterm pregnancy is defined as one that<br \/>\n00:41<br \/>\nhas reached between 41 and 0 days and 41<br \/>\n00:44<br \/>\nand 6 days a post term pregnancy is<br \/>\n00:46<br \/>\ndefined as beyond 42 weeks the most<br \/>\n00:49<br \/>\ncommon cause of post term pregnancies is<br \/>\n00:51<br \/>\ninaccurate estimation of gestational age<br \/>\n00:53<br \/>\nthe patient&#8217;s LMP date can accurately<br \/>\n00:55<br \/>\npredict the EDD if she has regular<br \/>\n00:57<br \/>\n28-day cycles ultrasound helps more<br \/>\n01:00<br \/>\naccurately determine the EDD when used<br \/>\n01:02<br \/>\nin conjunction with LMP dating the<br \/>\n01:04<br \/>\nmorbidity and mortality risk for both<br \/>\n01:06<br \/>\nmother and fetus increased with post<br \/>\n01:08<br \/>\nterm pregnancy maternal risks include<br \/>\n01:10<br \/>\nincreased risks of maternal vaginal<br \/>\n01:12<br \/>\ntrauma and cesarean delivery cesarean<br \/>\n01:15<br \/>\ndelivery increases the risk of infection<br \/>\n01:16<br \/>\nbleeding thromboembolic event and<br \/>\n01:19<br \/>\nvisceral injury fetal risks include<br \/>\n01:21<br \/>\nincreased risk of macrosomia post<br \/>\n01:23<br \/>\nmaturity syndrome meconium aspiration<br \/>\n01:25<br \/>\nsyndrome and a loggerhead romeo&#8217;s<br \/>\n01:26<br \/>\nmacrosomia increases the risk of<br \/>\n01:29<br \/>\noperative vaginal delivery cesarean<br \/>\n01:31<br \/>\ndelivery and shoulder dystocia<br \/>\n01:32<br \/>\nmacrosomia is defined as an infant<br \/>\n01:34<br \/>\ngreater than 4,500 grams and it occurs<br \/>\n01:37<br \/>\nin two to ten percent of post term<br \/>\n01:39<br \/>\npregnancies post maturity syndrome is<br \/>\n01:42<br \/>\nassociated with an aging placenta it<br \/>\n01:44<br \/>\ncomplicates 10 to 20 percent of post<br \/>\n01:46<br \/>\nterm pregnancies these fetuses have<br \/>\n01:48<br \/>\ndecreased subcutaneous fat and lack<br \/>\n01:51<br \/>\nvernix and lanugo the incidence of<br \/>\n01:54<br \/>\nmeconium passage increases as<br \/>\n01:55<br \/>\npregnancies become prolonged and this<br \/>\n01:57<br \/>\nleads to an increased risk of meconium<br \/>\n01:59<br \/>\naspiration syndrome<br \/>\n02:00<br \/>\nmeconium aspiration syndrome can lead to<br \/>\n02:03<br \/>\nsevere respiratory distress from<br \/>\n02:05<br \/>\nmechanical obstruction of both small and<br \/>\n02:07<br \/>\nlarge Airways as well as meconium<br \/>\n02:09<br \/>\nchemical pneumonitis Alico Hydra meiosis<br \/>\n02:12<br \/>\nrates increase with prolong<br \/>\n02:13<br \/>\npregnancy&#8217;s remember that the fetus will<br \/>\n02:15<br \/>\nalways try to protect blood flow to the<br \/>\n02:17<br \/>\nfetal brain when the fetus senses<br \/>\n02:19<br \/>\ndecreased placental flow it will deep<br \/>\n02:21<br \/>\nprioritize blood flow to the kidneys in<br \/>\n02:23<br \/>\norder to preserve blood flow to the<br \/>\n02:24<br \/>\nbrain<br \/>\n02:24<br \/>\nthis results in decreased urine<br \/>\n02:26<br \/>\nproduction the rates of intrauterine<br \/>\n02:28<br \/>\nfetal demise increase after 41 weeks<br \/>\n02:31<br \/>\nestimated gestational age let&#8217;s move on<br \/>\n02:33<br \/>\nto interventions first and foremost<br \/>\n02:36<br \/>\nthere should be accurate assessment of<br \/>\n02:38<br \/>\ngestational age ultrasound measurements<br \/>\n02:40<br \/>\nshould be used to confirm the estimated<br \/>\n02:42<br \/>\ndate of delivery membrane sweeping has<br \/>\n02:44<br \/>\nbeen associated with a decreased risk of<br \/>\n02:45<br \/>\nlate term and post term pregnancies in<br \/>\n02:48<br \/>\nthis procedure an OB provider gently<br \/>\n02:50<br \/>\nsweeps the amniotic sac away from the<br \/>\n02:52<br \/>\nuterine wall at the level of the cervix<br \/>\n02:54<br \/>\nand\/or lower uterine segment although<br \/>\n02:57<br \/>\nthis procedure is uncomfortable for<br \/>\n02:58<br \/>\npatients it can release prostaglandins<br \/>\n03:00<br \/>\nthat increase the chance of spontaneous<br \/>\n03:02<br \/>\nlabor antepartum fetal surveillance<br \/>\n03:04<br \/>\nshould be initiated at 41 weeks given<br \/>\n03:06<br \/>\nthe increased risk of intrauterine fetal<br \/>\n03:07<br \/>\ndemise and finally induction of labor<br \/>\n03:10<br \/>\nshould occur between 41 and 42 weeks<br \/>\n03:13<br \/>\nestimate of gestational age this<br \/>\n03:15<br \/>\nconcludes the aapko video on post term<br \/>\n03:17<br \/>\npregnancies we reviewed a normal<br \/>\n03:19<br \/>\npregnancy duration the importance of<br \/>\n03:21<br \/>\nobtaining an accurate assessment of the<br \/>\n03:22<br \/>\nestimated due date and reviewed<br \/>\n03:24<br \/>\ninterventions for trying to decrease the<br \/>\n03:25<br \/>\nmorbidity and mortality associated with<br \/>\n03:27<br \/>\npost term pregnancies<\/p>\n<p><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Duration = 3:41<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":46,"menu_order":30,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-222","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/brooksidepress.org\/basic_obgyn\/wp-json\/wp\/v2\/pages\/222","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/brooksidepress.org\/basic_obgyn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/brooksidepress.org\/basic_obgyn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/basic_obgyn\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/basic_obgyn\/wp-json\/wp\/v2\/comments?post=222"}],"version-history":[{"count":4,"href":"https:\/\/brooksidepress.org\/basic_obgyn\/wp-json\/wp\/v2\/pages\/222\/revisions"}],"predecessor-version":[{"id":1279,"href":"https:\/\/brooksidepress.org\/basic_obgyn\/wp-json\/wp\/v2\/pages\/222\/revisions\/1279"}],"up":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/basic_obgyn\/wp-json\/wp\/v2\/pages\/46"}],"wp:attachment":[{"href":"https:\/\/brooksidepress.org\/basic_obgyn\/wp-json\/wp\/v2\/media?parent=222"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}