Postdate pregnancy Part I. A literature review

Postdate pregnancy Part II. Clinical implications

“…The actual incidence of postdate pregnancy has been reported at between 2.2 and 10.4% and is greater in prospective studies 4 . The incidence of truly prolonged pregnancy within the postdate population is not greater than 30%.…”

“…Many clinical situations would not have such a high proportion of women with reliable menstrual histories and the degree of error in dating could be expected to be even greater. The incidence of postmaturity occurring within the postdate population has ranged from 8.6 to 26% 4 …”

“…The question becomes one of identifying the fetus at risk. Statistically, no more than three in ten well‐dated pregnancies classified as postdate will actually exceed 40 weeks' conceptional age, and of those three, one or two will be postmature 4 . If 10% of a population of pregnant women are still pregnant at 42 weeks, what is the best method of identifying the few at risk for postmaturity?…”

“…The biophysical profile has proved to be a very valuable tool in the examination of the postdate patient. Studies have demonstrated that when ultrasound scanning to determine amniotic fluid volume, fetal movement, tone, respiratory effort, and ponderal index is used in the overall evaluation of the postdate patient, infant outcome is improved 4 . The biophysical profile shows great promise in becoming the method of diagnosing postmaturity prenatally.…”

“…The school of thought that discouraged intervention was centered in the United States: “When the apple is ripe it will fall”; 1 and was countered by the British who believed that prolonged pregnancy was a significant and avoidable hazard 2 , 3 . More current research on this side of the Atlantic continues to support a “watchful waiting” approach without routine induction 4 …”