Prolonged pregnancy

1. Big picture

Prolonged pregnancy is clinically important because the fetus remains in utero beyond the expected term period, while placental function may progressively decline and the risk of stillbirth, oligohydramnios, meconium aspiration, macrosomia, shoulder dystocia, operative delivery, and neonatal morbidity increases.

The examiner mainly wants to hear this logic:

First confirm the gestational age. Then assess fetal wellbeing and amniotic fluid. Then decide between induction of labor and close surveillance.

The biggest trap is diagnosing “post-term pregnancy” from an uncertain last menstrual period without early ultrasound dating.

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