It is quite common for some women to deliver post their due date. In fact, studies show that a baby may be born on its predicted due date only 4 percent of the time. This means that not only should you be prepared for such a scenario, you will also need to be aware about post-term complications.
What Is A Post-term Baby?
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The normal length of pregnancy is 37 to 38 weeks and six days.
On the other hand, a full term is 39 weeks to 40 weeks and six days.
Meanwhile, a late-term is 41 weeks to 41 weeks and six days. The baby born after 42 weeks falls under the post maturity period. An early-term or post term are completely normal as only a handful of woman deliver on their estimated due date.
What Causes Post Maturity In Newborns?
Several reasons cause post maturity in newborns. Sometimes, it could be as simple as a wrong calculation from the last menstrual period that may push the due date by a week or two.
This could also lead to an early-term. Nevertheless, an ultrasound in the first trimester of the pregnancy does give a more accurate date of the pregnancy period.
Another reason that could cause post maturity is if the woman has had a previous post term pregnancy. Women born post term also have a genetic possibility of an increased risk of post term pregnancy.
Who Is Most At Risk During Post Mature Delivery?
Those at risk during post maturity pregnancies include:
1. Male baby
There is a possibility that pregnancies can turn post term in the case of a male baby. Studies prove that the mean gestational age of pregnancies with a male foetus are higher than female foetuses (26.5% vs 22.5%).
2. Older mother
Studies also prove that women conceiving children at a late age (above 35 years) as compared to women in their early to mid-20s may face problems of post term pregnancy.
3. Obese mother
Post term can also be a problem with mothers that have pre-existing obesity. Studies prove that women with BMI of 23–27.5 kg m−2 (overweight) and >27.5 kg m−2 (obese) have higher chances of late deliveries. Your healthcare provider will usually ask you to follow a more regular diet during the pregnancy term to minimise the risk of post maturity.
4. Mother or father with a personal history of post maturity
Post term pregnancy can be genetic and could be a result of either parent being born in post term. If the father or the mother was post term babies, chances are high the child will be too.
What Are The Risks In Post Maturity To The Foetus?
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A post term pregnancy beyond 42 weeks can put the foetus at risk in many ways. Some of these are listed below:
1. Stillbirth
There is an increased risk of stillbirth or infant death in post term pregnancies. However, the risk factor is extremely small with four to seven deaths seen in every 1,000 deliveries. In comparison, the risk of stillbirth in early term and full-term pregnancies stands at two to three cases per 1,000 deliveries.
2. Larger body size
There are likely to be delivery complications due to the baby’s larger size in post term pregnancies. Called macrosomia, this happens when the baby is over 10 pounds or 4500 grams.
3. Fetal dysmaturity
Some post term foetuses stop gaining weight after the due date, a condition called foetal dysmaturity. This occurs due to a problem with the delivery of blood to the foetus through the placenta. Post-birth, the baby may show signs of malnourishment with long arms and legs, loose skin, and thick scalp hair.
In the long term though, foetal dysmaturity does not have an effect on the infant’s growth.
4. Meconium aspiration
There is a possibility that the foetus will have a bowel movement, called meconium, into the amniotic fluid. The foetus may inhale some of the meconium-stained amniotic fluid under stress and could have breathing problems after birth.
What are the risks in post maturity to the mother?
In post term pregnancies, the mother is likely to face difficulties during labour. This includes injury to the perineum including the vagina, labia, and rectum.
There is also a possibility of prolonged labour, difficulty passing through the birth canal due to shoulder dystocia and birth trauma that includes fractured bones or nerve injury due to the larger size of the baby.
How To Prevent Post Term Complications In Newborns?
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Your healthcare provider will recommend tests on the foetus when the pregnancy enters the post term period. The antenatal foetal monitoring test gives information about the health of the foetus and the risks related to the pregnancy from this point.
Healthcare providers will also recommend the non-stressing test that monitors the baby’s heart rate with a small device. The device uses sound waves to measure the baby’s heart rate over a period of 20 to 30 minutes. Normally, the baby’s baseline heart rate is between 110 and 160 beats per minute (BPM) and should increase by at least 15 BPM for 15 seconds several times during the test.
The healthcare provider is likely to also recommend a biophysical profile score to assess the foetus’s health. This is a more comprehensive test and comprises non-stress testing and ultrasound measurement of four foetal parameters – foetal body movements, breathing movements, foetal tone, and amniotic fluid volume.
It is extremely important that the amniotic fluid volume remains stable for the health of the baby.
How Can You Treat Post Maturity In Newborns?
As an expectant mother, you can get restless during the post term period of the pregnancy. However, it can get hard to determine the optimal delivery time during this stage. However, the mother and the healthcare provider can decide if they want to consider inducing labour after monitoring the mother and foetus.
Labour can be induced with a medication applied directly to the cervix or in the vagina, which causes the cervix to soften and dilate. Inducing labour will likely take more time in women whose cervix is not dilated or thinned yet.
In case of complications, especially if the foetus is very large, some mothers will have to opt for a Caesarean delivery, more commonly known as a C-section. The mother and the healthcare professional could also opt for this route in case of a previous Caesarean delivery or for personal reasons.
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