Prolonged pregnancy: when should we intervene?
OBJECTIVE
Prolonged (postterm) pregnancies are associated with both fetal and maternal complications. A variety of management practices can be utilized to mitigate the risk of these complications.


RESULTS
In addition to routine induction of labor at 41 weeks, a number of alternative management strategies show promise in preventing adverse fetal outcomes. The routine use of ultrasonography for pregnancy dating lowers the rate of postterm pregnancy and is associated with less need for induction of labor. In the era of cervical ripening, routine induction of labor at 41 weeks does not increase the overall cesarean delivery rate.


CONCLUSIONS
Prolonged (postterm) pregnancies, although less common in the era of ultrasound dating, are associated with fetal and maternal risks. The authors favor routine induction of labor at 41 weeks in women with low-risk singleton gestations.
Doherty
Leo
L
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
Norwitz
Errol R
ER
D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007751:Labor, Induced; D009774:Obstetrics / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011273:Pregnancy, Prolonged; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography / Q000379:methods