Beatrix Mita Sadipun studies History of Accounting Thought and Kesehatan. Abstract. Background: Intrauterine growth restriction (IUGR) is an obstetrical IUGR are reviewed, and a management strategy is suggested. Prolonged rupture of membranes. Familial predisposition. Maternal hypertension or toxemia. Cesarean section without labor. IUGR/SGA. Perinatal asphyxia.
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Although multiple studies have used PG to induce labour in postterm pregnancies, no standardized dose or dosing interval has been established. Induction of labour before 42 weeks of gestation has the potential to prevent these complications; however, both patients and clinicians alike are concerned about risks associated with induction of labour such as failure of induction and increases in CS rates. The risk of meconium-stained amniotic fluid was reduced, but the risks of meconium aspiration syndrome and neonatal seizures were unaffected Crowley, However, there is no consistent definition of oligohydramnios in the postterm pregnancy.
Aetiology and risk factors The most common cause of prolonged pregnancies is inaccurate dating Neilson, ; Crowley, In a large, prospective, follow-up study of children at ages 1 and 2 years, the general intelligence quotient, physical milestones, and frequency of intercurrent illnesses were not significantly different between normal infants born at term and those born postterm Shime et al.
This would lower the stillbirth rates in postterm pregnancies as once the fetus is delivered it is no longer at risk of intra-uterine fetal death IUFD. Intracervical prostaglandins for induction of labour.
Cochrane systematic reviews demonstrated that prostaglandins PGs improve cervical ripeness and could initiate uterine contractions Boulvain et al.
To have a better understanding of the pathogenesis of postterm pregnancy it is essential to shed some lights on the pathophysiology of parturition and try to understand why these mechanisms fail to be triggered in postterm pregnancies or conversely are triggered earlier in preterm labour.
The main concern around induction of labour in postterm low risk pregnancies is related to uterine overstimulation, fetal distress, failure of induction and igr in caesarean section rates. When should we intervene?
Beatrix Mita Sadipun –
Int J Feto-Maternal Med. These risks are greater than it was originally thought. A role for estriol in human labor, term and preterm. To avoid formal induction and encourage spontaneous onset of labour at term, several minimally invasive interventions have been recommended.
Gene expression of leptin, mkaalah, and adiponectin in the white adipose tissue maoalah obese patients with non-alcoholic fatty liver disease and insulin resistance. Effect of coitus at term on length of gestation, induction of labor, and mode of delivery.
Postterm pregnancy is also associated with increased costs related to antenatal fetal monitoring and induction of labour Allen et al. Low pregravid body mass index as a risk factor for preterm birth: Maternal risks Postterm pregnancy is associated with significant risks to the mother.
The current definition and management of postterm pregnancy have been challenged in several studies as the emerging evidence demonstrates that the incidence of complications associated with postterm pregnancy also increase prior to 42 weeks of gestation. For example lugr incidence of stillbirth increases from 39 weeks onwards with a sharp rise after 40 weeks of gestation.
A Cochrane review on breast stimulation for cervical ripening and induction of labour Kavanagh et al. Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination. Gestational age-dependent reference values for pH in umbilical cord arterial blood at term.
For this complication alone, the increase in and among women experiencing caesarean deliveries accounted for the bulk of the increase by gestational age Caughey et al. Effective Care in Pregnancy and Childbirth. Labor characteristics of makallah prolonged pregnancies after induction with intracervical prostaglandin E2 gel versus intravenous oxytocin. A Cochrane systematic review in found a similar reduction in the overall rates of induction of labour for postterm pregnancy OR, 0.
In conclusion, acupuncture cannot be definitely assessed because of the paucity of trial data and the need for further evaluation Rabl et al.
Risk of recurrence of prolonged pregnancy. Caesarean delivery is associated with higher incidence of endometritis, haemorrhage, and thrombo-embolic disease Alexander et al.
Electro-acupuncture in relieving labor pain. Perinatal mortality per ongoing pregnancies. Changing obstetric practices associated with decreasing incidence of meconium aspiration syndrome.
Comparison of pre-induction ultrasonographic cervical length and Bishop score in predicting risk of cesarean section after labor induction with prostaglandins. Ultrasound assessment of amniotic fluid volume appears to be important. As such, no firm recommendation can be made for this particular group ACOG, Population characteristics that affect the prevalence include: Another study of this issue, showed that prolonged pregnancy is less common in women dated by ultrasound before 12 weeks compared with women scanned between 12 and 24 weeks 2.
Risk of Stillbirth by week of gestation rate calculated per ongoing pregnancies Sutan et al. This conclusion has not been universally accepted Cardozo et al. Similar to neonatal outcomes, maternal morbidity also increases in term pregnancies before 42 weeks of gestation. Maternal plasma CRH concentrations correlate with oestriol concentrations Smith et al.
The link between ethnicity and overall duration of pregnancy is not well established Collins et al. Forty weeks and beyond: