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A Critical Review of the Recent Literature on Postterm Pregnancy and a Look at Women's Experiences
Author(s) -
Shearer Madeleine H.,
Estes Milton
Publication year - 1985
Publication title -
birth
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.233
H-Index - 83
eISSN - 1523-536X
pISSN - 0730-7659
DOI - 10.1111/j.1523-536x.1985.tb00947.x
Subject(s) - medicine , obstetrics , forceps , pregnancy , oligohydramnios , cardiotocography , incidence (geometry) , meconium , gestation , amnioinfusion , fetus , fetal monitoring , placental insufficiency , gynecology , placenta , surgery , genetics , physics , optics , biology
The incidence of postterm pregnancy varies from 2.9 to 25 per cent in recent studies. Likewise, the incidence of macrosomia, oligohydramnios, and meconium vary widely, probably because of unavoidable inclusion of term pregnancies among postterm study samples. The debate over the extent and importance of uteroplacental insufficiency is reflected in contradictory findings regarding the “postmature” infant. Since 1978 reports on the management of postterm pregnancy agree that no improvement is made by routine termination of pregnancy at 42 weeks of gestation. Studies of cervical ripening are described. Fetal surveillance is discussed with emphasis on the recent work on fetal movement counting, the fetal biophysical profile, and antepartum cardiotocography. We interviewed 32 women who went a mean of 18.69 days past term. Twenty‐three women's own calculations agreed with their physicians'; these women delivered a mean of 15 days postterm. Eight had no fetal surveillance tests and there was one cesarean, one induction, one vacuum extraction, and one forceps delivery. Eight women reported their own dates to have been from 9–25 days closer to their actual deliveries than the dates calculated by their doctors. Six of these women had their dates changed during pregnancy based on sonograms. There were three each inductions, cesarean sections, and augmentations, as well as two epidurals and forceps deliveries, and three vaginal deliveries.