Management of Late-Term and Postterm Pregnancy.

Area of Science:

• Maternal-Fetal Medicine
• Obstetrics

Background:

• Postterm pregnancy is defined as 42 weeks' gestation.
• Late-term pregnancy spans 41 weeks' 0 days to 41 weeks' 6 days' gestation.
• Accurate first-trimester dating is crucial for gestational age verification.

Purpose of the Study:

• To evaluate the optimal timing for labor induction in late-term and postterm pregnancies.
• To assess the risks and benefits of induction versus expectant management.

Main Methods:

• Review of current literature and guidelines.
• Analysis of risks associated with prolonged gestation.
• Examination of outcomes following labor induction at various gestational ages.

Main Results:

• Induction at 41 weeks' gestation reduces perinatal mortality and stillbirth.
• Elective induction at 39 weeks' gestation may decrease cesarean deliveries and hypertensive disorders in low-risk nulliparous patients.
• Risks of fetal mortality, NICU admission, and stillbirth increase after 42 weeks' gestation.

Conclusions:

• Induction of labor before 42 weeks' gestation is recommended to decrease adverse perinatal outcomes.
• Shared decision-making regarding delivery timing is essential.
• The American College of Obstetricians and Gynecologists recommends induction by 42 weeks' gestation and considering elective induction at 39 weeks' gestation for low-risk nulliparous patients.