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Prolonged pregnancy: when should we intervene?

Doherty, Leo; Norwitz, Errol R

Current Opinion in Obstetrics & Gynecology: December 2008 - Volume 20 - Issue 6 - p 519–527
doi: 10.1097/GCO.0b013e328314b6f8
Women's health: Edited by Gubby Ayida and Joseph Aquilina

Purpose of review: 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.

Recent findings: 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.

Summary: 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.

Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA

Correspondence to Errol R. Norwitz, MD, PhD, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, LCI 800, New Haven, CT 06520, USA Tel: +1 203 785 5855; fax: +1 203 737 1883; e-mail: errol.norwitz@yale.edu

© 2008 Lippincott Williams & Wilkins, Inc.