Medicine an Surgery notes

Apr 24th, 2015
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POST TERMSALWA NEYAZIASSISTANT PROF.& CONSULTANT OBGYN KSUINTRODUCTIONDefinition 42 completed wks 294 days from LMPRisks adverse neonatal & fetal outcome / perinatal death Now it is believed that the risk is as early as 41 wksIncidence 41 27% 42 4-14% 43 2-7% The incidence is decreasingDating of pregnancy Accurate dating of pregnancy is essential to avoid unnecessaryintervention U/S scan prior to 20 wks gestation is an excellent method ofestablishing or confirming true gestational age Routine U/S scanning rate of IOL for post-termADVERSE PERINATAL OUTCOME ASSOCIATEDWITH POST-TERM PREGNANCY risk of perinatal death (antepartum, intrapartum, postpartum)due to anomalies eg. Anencephalyintrauterine infectionsasphyxia with or without meconium risk of neonatal morbidity - macrosomia- shoulder dystocia- meconium aspiration- admission to NICU- Rx with +ve pressure oxygen-endotracheal intubationrespiratory distresspersistent fetal circulationpneumoniaseizuresrisk of IOL, fetal distress in labor, meconium, & operativedeliveries risk of post-term adverse outcome in women withHPT, PET,DM , abruptio placenta, & IUGRMANAGEMENT1-Establishing gestational age HX ( in the 1st visit )LMP regularity & length of the cycle OCP in the last 3 cycle before conception Exam. Size of the uterus corresponding to dates or not

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