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"I'm past my due date" ... Recommendations Regarding Post-Term Pregnancy

In the US approximately 28% of pregnancies deliver in the week of the due date or within the week following the due date (40-41 weeks pregnancy.)  Another 5 % of births occur in the second week past the due date (42 weeks.)   So it’s possible that you may have about a 30% chance of still being pregnant past your due date.  For some women, the continued uncertainty of not knowing when they’ll go into labor is, understandably, both frustrating and concerning.  Though the overall chance of an untoward fetal outcome (including neonatal illness, intensive care admissions and stillbirth) are low, studies do show these risks to increase as pregnancy continues past 41-42 weeks.

 

A large Cochrane review study comparing expectant management (allowing labor to occur naturally, on its own) with labor induction in post-term pregnancies, showed that induction of labor was associated with a decreased risk of meconium aspiration syndrome, cesarean section delivery, and perinatal death.  More simply stated, the risks of certain fetal and maternal complications were lessened, with proceeding with labor induction at postterm, as opposed to waiting longer to spontaneous labor to occur.

Not all labor ‘inductions’ need to include the use of medications.  ‘Stripping the membranes’ (a digital cervical exam separating the amniotic membranes from the lower uterine segment, performed by your healthcare provider at or near your due date) may help to ‘induce’ natural, spontaneous labor.  The most recent Cochrane study review on membrane sweeping demonstrated it’s association with a significant reduction in pregnancies continuing beyond 41 weeks…So it has a good chance of working in terms of putting you into labor.

Based on the concerns for increased neonatal morbidity and mortality, ACOG (The American Congress of Obstetricians and Gynecologists) recommends the consideration of labor induction by 41-42 weeks gestation.



Suzanne Hall, MD (@drsuzyyhall)


Eastside Gynecology Obstetrics, PC

Ofiices located in Grosse Pointe, Roseville, Macomb, Rochester Hills, MI

 

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