Medical Archive

Introduction

• ??: 42+0~ (TWIN: 38+0~)
• Nullipara, ??, ?? ?, ??? ??? ???
• ??? ?? ??: Anencephaly, adrenal hypoplasia
• ? ? ?? ??: NST, CST, BPP, ????

Estimated gestational age

• Late-term: ?41 weeks gestation
• Post-term: ?42 weeks gestation

Incidence

• Risk factors
  • Prior post-term pregnancy
  • Nulliparity
  • Obesity
  • Age ?35
  • Fetal anomalies (eg, anencephaly)

Perinatal mortality and morbidity

Pathophysiology

Postmaturity syndrome

Placental dysfunction

Late- and post-term pregnancies are at risk of decreased placental function d/t age-related placental changes (eg, infarctions, calcifications) that cause increased placental vascular resistance.

Fetal distress and oligohydraminos

1. Progressive placental dysfunction
2. Uteroplacental insufficiency
3. Fetal hypoxemia
4. Blood is preferentially distributed to the brain rather than peripheral tissue.
5. Oligohydraminos

Fetal-growth restriction

Complications

Oligohydraminos

38? ?? ?? ?? ??

Macrosomia

Macrosomia: 5,000g?? vaginal delivery (DM? 4,500g)

Antepartum management

Induction factors

Induction versus fetal testing

Management strategies

Intrapartum management

• ???? ??? 3??. ?? ??? ??f/u
  • 42? ??? ?? (ripening ?? ???)
  • ?? ??
  • ?????
• Prognostic factor
  • Station of vertex. ??? ?? CPD ?