Post-term Pregnancy: Epidemiology, Outcomes, and Management

The term pregnancy ranges from 37 and 0/7 weeks’ gestation to 41 6/7 weeks’ gestation; a pregnancy that progresses to 42 weeks and beyond is deemed a postterm pregnancy. Such pregnancies are uncommon, in well dated pregnancies, likely less than 3-5 percent. However, because of induction of labor, in the United States it is less than 1%. Postterm pregnancy is associated with a number of complications including stillbirth, meconium, both fetal growth restriction and fetal macrosomia, birth injury, preeclampsia, cesarean delivery, operative vaginal delivery, chorioamnionitis, and postpartum hemorrhage. One of the primary reasons for induction of labor prior to 42 weeks is that it has been associated with a lower risk of many of these complications including cesarean delivery. In women who do not wish to undergo induction of labor, antenatal testing is indicated certainly by 41 weeks of gestation and is commonly used at earlier gestations. This review contains 1 table, 2 figures and 83 references Key words: cesarean, induction, late term, acrosomia, meconium, postterm, stillbirth, term