Screening for fetal and neonatal risk in the postdate pregnancy

One hundred four postdate pregnancies were managed according to a well-defined protocol calling for weekly oxytocin challenge tests and urinary estriols three times per week. Although the perinatal mortality rate in these patients was not increased there was a significant increase in the incidence of neonatal morbidity and complications. The clinical syndrome of dysmaturity was seen in 20 per cent of the neonates. When meconium was present in the amniotic fluid the incidence of neonatal and fetal complications was higher. The cesarean section rate was twice the normal rate, with nonprogression of labor being the commonest indication. It is recommended that: (1) pregnancies carried beyond 42 weeks do not require termination simply because they are post dates; (2) all postdate patients should be monitored during labor; (3) trained personnel to initiate neonatal resuscitation should be present at each postdate delivery.