What Is Overdue Pregnancy?
A full-term pregnancy typically lasts between 39 and 40 weeks, around 280 days from the first day of the last period. Babies born after 40 weeks or 280 days are considered overdue. However, every baby is different, and there is a wide range of what is normal when babies arrive. A late-term or post-term pregnancy may be associated with some risks, but the length of pregnancy varies. Many doctors induce labor only after 42-week of pregnancy.
What Causes Overdue Pregnancy?
Overdue pregnancy can happen due to the following reasons:
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First pregnancy.
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A history of overdue pregnancy.
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A history of overdue pregnancy in the family.
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If the baby is a boy.
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If the due date was calculated incorrectly, it could be due to confusion over the exact date of the start of the last menstrual period or if the due date was based on a second or third-trimester ultrasound.
How to Manage an Overdue Pregnancy?
The healthcare provider may do a membrane swap to check if it will trigger labor. During the membrane swap, an index finger is inserted into the cervix. A circular movement is made using the finger to separate the amniotic sac's membranes. This action releases prostaglandins and prepares the cervix for birth. If the labor does not start even after the membrane swap, the health care providers will suggest a date to have the induced labor, when the doctor or midwife uses drugs or tools and techniques to start the labor. The induction of labor is always planned. It will be helpful to discuss the advantages and disadvantages with the doctor and midwife and determine why they think the labor should be induced. It is the choice of the mother and family whether to have the labor induced or not. If the pregnancy is overdue, the doctors or midwife will always monitor changes in the baby's movements, including an unusual increase, decrease, or stopping altogether.
What Are the Tests Done to Monitor the Health of Fetus?
At each of the appointments after the due date, the doctor will check the baby's size and position, monitor the baby's heart rate, and enquire about the baby's movement. The doctor may even suggest extra monitoring and medical tests to ensure the baby is healthy.
Testing may occur once or twice a week and can include the following:
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Contraction Stress Test (CST) - This test measures the baby's heartbeat when the uterus is contracting to find out if there is fetal distress.
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Nonstress Test (Nst) - This measures the baby's heartbeat for some time, usually around 15 minutes.
- Biophysical Profile (BPP) - This is a combination test of ultrasound examination and fetal heart rate monitoring. This test allows the doctor to check the fetal heart rate, muscle tone, and movement. The level of amniotic fluid can also be assessed during the ultrasound.
- Cervical Examination - This examination allows the doctor to determine the condition of the cervix. The cervix is fully dilated and effaced during labor, so the doctor may check for any ripening signs and other changes that may indicate labor.
How Is Labor Decided in Overdue Pregnancy?
Depending on the results of these procedures, the doctor may decide whether induced labor is required or not. Depending on the mother's age, the pregnancy's health, the mother's health history, and the birthing wishes of the parents-to-be, induced labor may be planned.
The doctor will check that both mother and the baby are healthy using an ultrasound scan to check the baby's movement and heartbeat. The ultrasound might show whether the placenta is supplying as much oxygen and nutrients to the baby as it was. If not, in such cases, the doctor will probably suggest an induction or a C-section. If the ultrasound shows that the baby is fine and the mother's health is good, the mother can choose to wait and see whether labor starts naturally. If the pregnancy lasts longer than 42 weeks and the mother decides not to have the labor induced, the mother should be offered increased monitoring to check her baby's well-being.
What Is the Risk of Overdue Pregnancy?
Many researchers say that when pregnancy extends after 41 weeks, the baby might be at increased risk of health problems, including:
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Fetal Macrosomia - The baby will be significantly larger than average at birth, which may increase the risk of a vaginal delivery, C-section, or getting a shoulder stuck behind the pelvic bone during delivery.
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Postmaturity Syndrome - It is characterized by the baby not gaining weight after the due date, which can be due to decreased fat beneath the skin, loose or dry skin, and long fingernails and toenails at birth.
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Oligohydramnios - It occurs when the amniotic fluid level is low, which can compress the umbilical cord during contractions and affect the baby's heart rate.
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Meconium - When the meconium (the first feces of the newborn) enters the baby's lungs, it can lead to serious respiratory complications.
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Fetal Distress - It occurs when the heartbeat is slowed and other vital signs of the baby are in trouble.
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Stillbirth - The death of the baby before or soon after the birth.
Overdue pregnancies can also cause delivery complications like:
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Severe vaginal tears.
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Postpartum bleeding or hemorrhage.
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Infection.
What Can Be the Complications of Overdue Pregnancy?
Mostly there are no complications, and the doctors are happy to go a few days over the due date as long as the condition of the mother and baby is healthy. But, after 42 weeks, the baby's health may be at risk. Very few babies die unexpectedly if they are still in the womb beyond 42 weeks of pregnancy. The reason for the baby's death as the week passes is still unclear. Researchers suggest that it can be due to dysfunction of the placenta after the due date, which can cause a reduced supply of oxygen and nutrients to the baby.
Conclusion:
Most women become anxious when a pregnancy is overdue. It is important to stay calm and comfortable. Consult the health care providers, discuss the benefits and risks of overdue pregnancy, and guidelines for a safe way of pregnancy. The doctors will monitor the health of the mother and baby and decide whether to induce labor or go with C-section.
