a. Definition.

Postterm pregnancy is any pregnancy that goes beyond 42 weeks gestation.

b. Nursing Interventions in the Delivery of the Postterm Infant

(1) Notify and have a pediatrician present for delivery. The infant requires immediate assessment of his condition. In addition, the infant may need immediate intervention to establish adequate respiratory function.

(2) Perform tracheal suctioning immediately at delivery. In postterm pregnancy, the amniotic fluid is frequently thick since it decreases after 38 weeks. The infant frequently has a bowel movement (meconium) prior to or during labor due to stress. This fluid tends to clog the air passages and irritates the lungs when aspirated. Aspirated meconium-stained amniotic fluid can lead to meconium aspirations syndrome or pneumonia.

(3) Evaluate the newborn for hypoglycemia via dextrostix. The infant has been forced to use up energy stores due to prolonged pregnancy. Blood sugar less than 45 mg/dl is low and requires immediate oral glucose feedings, or IV glucose feeding followed by frequent formula feedings to prevent subsequent drops.

(4) Give special care to the infant to prevent loss of body heat. Place a hat on his head, keep him wrapped; then, and place him in a warm incubator. The postterm infant is subject to cold stress because of low amounts of subcutaneous fat and large body surface.