Postmaturity syndrome; the obstetrician's role in management

The obstetric problem of going past the date of expected confinement has no medical significance, provided the fetus in its demands does not outgrow placental capability. The problem of relative placental insufficiency, however, is a serious one with a total fetal wastage in the neighborhood of 15 per cent. Antepartum indications of such placental insufficiency have not yet been well documented. However, a decrease in the fundal measurements and particularly where associated with an otherwise unexplained loss of maternal weight has proved an ominous sign. In a study of application of reported criteria for determining when a patient is "at term" by vaginal cytologic methods, the results were approximately 75 per cent accurate. Cytologic studies when coupled with other physical findings may be of assistance in determining in which cases labor should be induced and in which the fetuses should be accorded the special attention that is demanded by the chronic state of low grade anoxia.