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Pregnancy risk increases from 41 weeks of gestation
1Department of Obstetrics and Gynecology, Oppland Central Hospital, Lillehammer, Norway. jnakling@online.no
Acta Obstetricia Et Gynecologica Scandinavica
|June 6, 2006
Summary
Conservative management of post-term pregnancies increases perinatal mortality and morbidity risks. The risks begin at gestational week 41, suggesting current guidelines for post-term pregnancy management need revision.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Maternal-Fetal Medicine
Background:
- Post-term pregnancies, defined as gestation 294 days or beyond, require careful evaluation for potential risks.
- Conservative management strategies for post-term pregnancies are common, but their impact on adverse outcomes needs thorough assessment.
Purpose of the Study:
- To evaluate the mortality and morbidity associated with conservatively managed post-term pregnancies.
- To determine the risks of perinatal mortality and morbidity in relation to gestational age in post-term pregnancies.
Main Methods:
- A population-based prospective study was conducted involving 17,493 women with singleton pregnancies in Norway (1989-1999).
- Inclusion criteria included a second-trimester ultrasound and delivery after 37 completed gestational weeks.
- Data analysis focused on comparing outcomes between term and post-term deliveries.
Main Results:
- Post-term deliveries (7.6%) showed a borderline significant increase in perinatal mortality (RR 2.0).
- Significantly higher rates of perinatal morbidity were observed, including low Apgar scores (RR 2.0) and neonatal intensive care unit transfers (RR 1.6).
- Perinatal death risk per 1000 ongoing pregnancies increased significantly from week 37, reaching 3.7 by week 42.
Conclusions:
- Expectant management of post-term pregnancies up to week 43 is associated with increased perinatal mortality and morbidity risks.
- These risks become significant starting from gestational week 41.
- Current clinical guidelines for managing post-term pregnancies should be revised to incorporate these findings.
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