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Management Of The Uncomplicated Term Pregnancy
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
However, these data are mixed and may vary based on whether risk factors such as fetal growth restriction (FGR) are included in the analysis. In a review of epidemiologic studies published between 1990 and 2004, 7 out of 11 studies demonstrated an increased stillbirth risk with postterm pregnancies, and 4 suggested that other issues such as FGR or fetal anomalies had a greater contribution to the stillbirth rate than did prolonged pregnancy [8].
DRCOG MCQs for Circuit C Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Oligohydramnios is associated with:<200 ml liquor volume during the third trimester of pregnancy.Urethral aplasia.Prolonged pregnancy.Potter's syndrome.Talipes.
Practice exam 2: Answers
Published in Euan Kevelighan, Jeremy Gasson, Makiya Ashraf, Get Through MRCOG Part 2: Short Answer Questions, 2020
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf
The risks associated with a prolonged pregnancy are the increasing perinatal mortality and morbidity (1). The risk of stillbirth increases from I in 3000 continuing pregnancies at 37 weeks’ gestation to 3 in 3000 at 42 weeks and 6 in 3000 at 43 weeks (1). There is a similar increase in neonatal mortality (1).
Impact of prolonged use of adjuvant tocolytics after cervical cerclage on late abortion and premature delivery
Published in Journal of Obstetrics and Gynaecology, 2023
Li-Rong Zhao, Shu-Jing Lu, Qing Liu, Ying-Chun Yu, Li Xiao
In this study, the presence of regular uterine contractions was considered the primary reason for administering uterine contraction inhibitors. Furthermore, if uterine contractions are inhibited effectively but adverse reactions occur, it should be considered as the reason to reduce the dose of the inhibitors; replace these inhibitors with other medications/treatments; a combination of treatments should be used, or these drugs should be discontinued. We found that prolonged pregnancy latency could increase the gestational age of delivery (p < .01). Forty patients delivered after 37 weeks of gestation, which reduced the premature delivery rate. Prolonged gestational age was negatively correlated with the longest duration of medication (p < .01). The gestational age was not significantly prolonged in patients with duration of medication use, indicating the complexity of late abortion and premature delivery. The duration of the medication was increased because uterine contractions could not be effectively inhibited. Hence, abortion and premature birth could not be avoided. We considered that it was vital to administer persistent uterine contraction inhibitors at the same time when cervical cerclage was performed as it can prolong gestational age and reduce premature birth rate.
Delivery outcomes in women with morbid obesity, where induction of labour was planned to prevent post-term complications
Published in Journal of Obstetrics and Gynaecology, 2022
J. D. Kammies, L. De Waard, C. J. B. Muller, D. R. Hall
The standard approach to prevent the foetal and maternal complications of prolonged pregnancy (beyond 42 weeks’ gestation), is to perform induction of labour (IOL) during the late-term week i.e., 41w0d-41w6d (Hall 2016). In a robust, multicenter, randomised, controlled trial, in which low-risk nulliparous women were assigned to IOL at 39 weeks’, or expectant management, for delivery no later than 42 weeks gestation, Grobman et al. reported that caesarean delivery was significantly lower, with less hypertensive disease in the IOL group (Grobman et al. 2018). For high-volume institutions with strict IOL policies, it is prudent to consider the influence of otherwise uncomplicated, morbid obesity on delivery outcomes, as increased rates of adverse outcomes have been reported. The availability of local, contextualised information is especially important in the counselling of patients, and also informs quality control and advancement.
Effectiveness and safety of membrane sweeping in the prevention of post-term pregnancy: a randomised controlled trial
Published in Journal of Obstetrics and Gynaecology, 2022
J. O. Salau, T. G. Onile, A. O. Musa, E. H. Gbejegbe, A. A. Adewole, G. O. Olorunfemi, A. M. Olumodeji
The incidence of prolonged pregnancy was 32.3%, 19.4%, and 11.7% respectively among the control group, once-weekly, and twice-weekly groups. This is similar to findings by Isah et al. (2019) in Abuja (37.1% in the control group versus 12.4% in the membrane sweep group) and Ugwu et al. (2014) in Nigeria (39.3% in the control group versus 16.1% in membrane sweep group). This may be attributed to stimulation of biochemical mediators like prostaglandins F2α, Phospholipase A2 and cytokines that subsequently improve and hastens cervical remodelling and ripening in addition to initiation of uterine contraction following membrane sweep as compared to non-sweep. Manual stretch on the cervix also helps to initiate the Fergusson reflex by releasing oxytocin thus promoting uterine contractility (Emuveyan 2015). The incidence of prolonged pregnancy in this study is however higher than that of Dare and Oboro (2002) study (16% in the control group versus 3% in the membrane sweep group). This may be because Dare and Oboro (2002) study were done earlier at 38 weeks and as such a long time to delivery and consequently reduced the absolute number of women undelivered at 41 weeks 3 days.