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Post Maturity

Notes on post maturity for you to easily understand Medical class

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osutarujennifer
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19 views

Post Maturity

Notes on post maturity for you to easily understand Medical class

Uploaded by

osutarujennifer
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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POST MATURITY

•Definition
•Incidence
•Causes
•Signs and symptoms
•Investigations
•Management
•Risk factors
•preventions
Post maturity
• Post maturity refers to any baby born
after 42 completed weeks of gestation or
294 days from the first day of the
mother's last normal menstrual period
(LNMP).
• Post term pregnancy is the condition of a
baby that has not yet been born after 42
weeks of gestation, two weeks beyond
the normal 40.
Incidence
• The frequency or incidence of
prolong pregnancy is about 5 to
10%.
• Post-mature births can carry risks for both the
mother and the infant, including fetal
malnutrition
• After the 42nd week of gestation, the placenta,
which supplies the baby with nutrients and
oxygen from the mother, starts aging and will
eventually fail.
• If the fetus passes its fecal matter, which is not
typical until after birth, and breathes it in, it
could become sick with meconium aspiration
syndrome.
• Post term pregnancy is one of the indication to
induce labor.
Causes
• The causes of post-term births are
unknown, but
• post-mature births are more likely
when the mother has experienced a
previous post-mature birth.
• nulliparity
• Male fetus
• Pre-pregnancy BMI of 25kg/m or more.
• Congenital anomalies like anencephaly.
• Post-mature births can also be attributed to
irregular menstrual cycles. Irregular
menstruation is very difficult to judge when
the ovaries would be available for fertilization
and subsequent pregnancy.
• Previous prolonged pregnancy suggest a
possibility of genetic influence with a
prolonged gestation as a normal variation on
human gestation.
• Some post-mature pregnancies are
because the mother is not certain of
her last period, so in reality the baby
is not technically post-mature.
• However, in most countries where
gestation is measured by ultrasound
scan technology, this is less likely.
Why is post maturity a concern? Or
associated risks and implication for
mother, fetus and baby
• To the fetus
• Post mature babies are born after the normal length
of pregnancy.
• The placenta, which supplies babies with the
nutrients and oxygen from the mother's circulation,
begins to age toward the end of pregnancy, and may
not function as efficiently as before.
• Other concerns include the following:
• Amniotic fluid volume may decrease and the fetus
• Risks can increase during labor and birth for a
fetus such as;
• poor oxygen supply(hypoxia, asphyxia) Bony
injury, soft tissue trauma, cerebral
haemorrhage
• Post mature babies may be at risk for
meconium aspiration, when a baby breathes in
fluid containing the first stool.
• Hypoglycemia (low blood sugar) can also occur
because the baby has already used up its
glucose-producing stores.
Risk to the mother
• Large for gestational age or macrosomic baby
which can lead to shoulder dystocia
• Genital tract trauma ( third degree tear).
• Postpartum haemorrhage
• Operative birth
• Prolonged labor
• Difficult deliveries
• Maternal distress.
Signs and symptoms of post maturity
• Dry, loose, peeling skin
• Overgrown nails
• Abundant scalp hair
• Visible creases on palms and soles of feet
• Minimal fat deposits
• Green, brown, or yellow coloring of skin from
meconium staining (the first stool passed
during pregnancy into the amniotic fluid)
• More alert and "wide-eyed"
• Doctors diagnose post-mature birth
based on the baby's physical
appearance and the length of the
mother's pregnancy.
• However, some post mature babies
may show no or few signs of post
maturity.
How is post maturity diagnosed?

• Post maturity is usually diagnosed by


a combination of assessments,
including the following:
• Baby's physical appearance
• Length of the pregnancy
• Baby's assessed gestational age
Treatment of post maturity

• Testing may be done for a post-term


pregnancy to check fetal well-being and
identify problems.
• Tests often include ultrasound, non stress
testing (how the fetal heart rate responds
to fetal activity),
• And estimation of the amniotic fluid
volume.
• Membrane sweep, Induction of labor or
Fetal and neonatal risks
• Reduced placental perfusion—Once a pregnancy has
surpassed the 40-week gestation period, doctors closely
monitor the mother for signs of placental deterioration.
• Toward the end of pregnancy, calcium is deposited on the
walls of blood vessels, and proteins are deposited on the
surface of the placenta, which changes the placenta.
• This limits the blood flow through the placenta and
ultimately leads to placental insufficiency, and the baby is
no longer properly nourished.
• Induced labor is strongly encouraged if this happens.
• Oligohydramnios
• Meconium aspiration
Maternal risks
• Large for gestational age: may lead to;
• Birth—Post-term babies may be larger than an
average baby, thus increasing the length of
labor.
• The labor is increased / prolonged because
the baby's head is too big to pass through the
mother's pelvis.
• This is called cephalopelvic disproportion.
• Caesarean sections are encouraged if this
happens.
• When post-mature babies are larger than
average, forceps or vacuum delivery may be
used to resolve the difficulties at the delivery
time.
• Difficulty in delivering the shoulders,
shoulder dystocia, becomes an increased risk.
• Increased psychological stress
• Probable labour induction
• Death (if the baby stayed for too long,
Maternal death) will occur
complications of post maturity in the
newborn
• Less amniotic fluid. This may stop the baby from gaining
weight or may even cause weight loss.
• Poor oxygen supply. Babies who don't get enough
oxygen may have problems during labor and delivery.
• Large size. A large baby may cause problems for the
mother during labor and delivery.
• Meconium aspiration. Babies who stay in the womb
longer are more likely to breathe in fluid containing
meconium.
• Hypoglycemia or low blood sugar. This happens when
the baby has already used up his or her stores of glucose.
preventions
• Knowing your due date is the best way to
know if your baby may be post-term.
• An ultrasound test early in pregnancy
can help your healthcare provider figure
out your baby’s age by checking the
baby’s size.
• Ultrasound is also a good way to
check the placenta for signs of aging.
Monitoring fetal condition
• Fetal movement recording; Regular
monitoring of movements of the baby is the
best sign indicating that it is still in good
health.
• The mother should keep a "kick-chart" to
record the movements of her baby. A rate of
fewer than 10 movements in 2 hours is not a
good sign, and a doctor should be contacted.
If there is a reduction in the number of
movements it could indicate placental
deterioration.
• Electronic fetal monitoring; Electronic fetal
monitoring uses a cardiotocograph to check the
baby's heartbeat and is typically monitored over a
30-minute period. If the heartbeat proves to be
normal, the doctor will not usually suggest induced
labor.
• Ultrasound scan; An ultrasound scan evaluates the
amount of amniotic fluid around the baby.
• If the placenta is deteriorating, then the amount of
fluid will be low, and induced labor is highly
recommended.
• Biophysical profile;
• A biophysical profile checks for the baby's heart
rate, muscle tone, movement, breathing, and the
amount of amniotic fluid surrounding the baby.
• Doppler flow study;
• Doppler flow study is a type of ultrasound that
measures the amount of blood flowing in and out of
the placenta.

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