Postterm Pregnancy
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Postterm Pregnancy
Postterm pregnancy is when a woman has not yet delivered her baby after 42 weeks of gestation, two weeks beyond the typical 40-week duration of pregnancy. Postmature births carry risks for both the mother and the baby, including fetal malnutrition, meconium aspiration syndrome, and stillbirths. After the 42nd week of gestation, the placenta, which supplies the baby with nutrients and oxygen from the mother, starts aging and will eventually fail. Postterm pregnancy is a reason to induce labor. Definitions The management of labor and delivery may vary depending on the gestational age. It is common to encounter the following terms when describing different time periods of pregnancy. * Postterm – ≥ 42 weeks + 0 days of gestation (> 293 days from the first day of last menstrual period, or > 13 days from the estimated due date) * Late term – 41 weeks + 0 days to 41 weeks + 6 days of gestation * Full term – 39 weeks + 0 days to 40 weeks + 6 days of gestation * Early term – 37 ...
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Obstetrics
Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field. Main areas Prenatal care Prenatal care is important in screening for various complications of pregnancy. This includes routine office visits with physical exams and routine lab tests along with telehealth care for women with low-risk pregnancies: Image:Ultrasound_image_of_a_fetus.jpg, 3D ultrasound of fetus (about 14 weeks gestational age) Image:Sucking his thumb and waving.jpg, Fetus at 17 weeks Image:3dultrasound 20 weeks.jpg, Fetus at 20 weeks First trimester Routine tests in the first trimester of pregnancy generally include: * Complete blood count * Blood type ** Rh-negative antenatal patients should receive RhoGAM at 28 weeks to prevent Rh disease. * Indirect Coombs test (AGT) to assess risk of hemolytic dis ...
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Obstetrical Forceps
Obstetrical forceps are a medical instrument used in childbirth. Their use can serve as an alternative to the ventouse (vacuum extraction) method. Medical uses Forceps births, like all assisted births, should only be undertaken to help promote the health of the mother or baby. In general, a forceps birth is likely to be safer for both the mother and baby than the alternatives – either a ventouse birth or a caesarean section – although caveats such as operator skill apply. Advantages of forceps use include avoidance of caesarean section (and the short and long-term complications that accompany this), reduction of delivery time, and general applicability with cephalic presentation (head presentation). Common complications include the possibility of bruising the baby and causing more severe vaginal tears (perineal laceration) than would otherwise be the case (although it is important to recognise that almost all women will sustain some form of tear when delivering their fir ...
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Prostaglandin
The prostaglandins (PG) are a group of physiologically active lipid compounds called eicosanoids having diverse hormone-like effects in animals. Prostaglandins have been found in almost every tissue in humans and other animals. They are derived enzymatically from the fatty acid arachidonic acid. Every prostaglandin contains 20 carbon atoms, including a 5-carbon ring. They are a subclass of eicosanoids and of the prostanoid class of fatty acid derivatives. The structural differences between prostaglandins account for their different biological activities. A given prostaglandin may have different and even opposite effects in different tissues in some cases. The ability of the same prostaglandin to stimulate a reaction in one tissue and inhibit the same reaction in another tissue is determined by the type of receptor to which the prostaglandin binds. They act as autocrine or paracrine factors with their target cells present in the immediate vicinity of the site of their secret ...
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World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of health". Headquartered in Geneva, Switzerland, it has six regional offices and 150 field offices worldwide. The WHO was established on 7 April 1948. The first meeting of the World Health Assembly (WHA), the agency's governing body, took place on 24 July of that year. The WHO incorporated the assets, personnel, and duties of the League of Nations' Health Organization and the , including the International Classification of Diseases (ICD). Its work began in earnest in 1951 after a significant infusion of financial and technical resources. The WHO's mandate seeks and includes: working worldwide to promote health, keeping the world safe, and serve the vulnerable. It advocates that a billion more people should have: universal health care coverag ...
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Biophysical Profile
A biophysical profile (BPP) is a prenatal ultrasound evaluation of fetal well-being involving a scoring system, with the score being termed Manning's score.Page 215
Chapter 39 on Biophysical Profile (BPP), in: Title: Diagnostic Ultrasound, Volume: 2, Issue: 1 of The Veterinary clinics of North America. Equine practice, Author: Norman W. Rantanen. Publisher: Jaypee Brothers Publishers, 1986. . Length: 261 pages It is often done when a (NST) is non reactive, or for other obstetrical indications. The "modified biophysical profile" consists of the NST and amniotic fluid index only.


Procedure
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Vibroacoustic Stimulation
Vibroacoustic stimulation (VAS), sometimes referred to as fetal vibroacoustic stimulation or fetal acoustic stimulation test (FAST), is the application of a vibratory sound stimulus to the abdomen of a pregnant woman to induce FHR (fetal heart rate) accelerations. The presence of FHR accelerations reliably predicts the absence of fetal metabolic acidemia. Vibroacoustic stimulation is typically used during a nonstress test (NST). In 2013, the Cochrane Database of Systematic Reviews concluded that there was insufficient evidence from randomized trials to support its use to assess fetal A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal develo ... well-being in labor. A related Cochrane Review, however, concluded that its use in antenatal testing did reduce the incidence of non-reactive cardiot ...
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Cardiotocography
Cardiotocography (CTG) is a technique used to monitor the fetal heartbeat and the uterine contractions during pregnancy and labour. The machine used to perform the monitoring is called a cardiotocograph. Fetal heart sounds was described as early as 350 years ago and approximately 200 years ago mechanical stethoscopes, such as the Pinard horn, were introduced in clinical practice. Modern-day CTG was developed and introduced in the 1950s and early 1960s by Edward Hon, Roberto Caldeyro-Barcia and Konrad Hammacher. The first commercial fetal monitor (Hewlett-Packard 8020A) was released in 1968. CTG monitoring is widely used to assess fetal wellbeing by identifying babies at risk of hypoxia (lack of oxygen). CTG is mainly used during labour. A review found that in the antenatal period (before labour), there is no evidence to suggest that monitoring women with high-risk pregnancies benefits the mother or baby, although research around this is old and should be interpreted with cautio ...
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Nonstress Test
A nonstress test (NST) is a screening test used in pregnancy to assess fetal status by means of the fetal heart rate and its responsiveness. A cardiotocograph is used to monitor the fetal heart rate and presence or absence of uterine contractions. The test is typically termed "reactive" (also "reassuring") or "nonreactive" (also "nonreassuring"). Premise The premise of the NST is that a well-oxygenated, non-acidemic fetus will spontaneously have temporary increases, termed "accelerations," in the fetal heart rate (FHR). Vibroacoustic stimulation can wake the fetus, and is sometimes used to speed up the test or to facilitate further evaluation of a non-reactive nonstress test. Interpretation A nonstress test can be classified as normal, atypical, or abnormal. A normal nonstress test will show a baseline fetal heart rate between 110 and 160 beats per minute with moderate variability (5- to 25-interbeat variability) and 2 qualifying accelerations in 20 minutes with no decelerations. ...
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Gestational Age (obstetrics)
In obstetrics, gestational age is a measure of the age of a pregnancy which is taken from the beginning of the woman's last menstrual period (LMP), or the corresponding age of the gestation as estimated by a more accurate method if available. Such methods include adding 14 days to a known duration since fertilization (as is possible in in vitro fertilization), or by obstetric ultrasonography. The popularity of using this definition of gestational age is that menstrual periods are essentially always noticed, while there is usually a lack of a convenient way to discern when fertilization occurred. Gestational age is contrasted with fertilization age which takes the date of fertilization as the start date of gestation. The initiation of pregnancy for the calculation of gestational age can differ from definitions of initiation of pregnancy in context of the abortion debate or beginning of human personhood. Methods According to American College of Obstetricians and Gynecologists, th ...
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The Guardian
''The Guardian'' is a British daily newspaper. It was founded in 1821 as ''The Manchester Guardian'', and changed its name in 1959. Along with its sister papers ''The Observer'' and ''The Guardian Weekly'', ''The Guardian'' is part of the Guardian Media Group, owned by the Scott Trust. The trust was created in 1936 to "secure the financial and editorial independence of ''The Guardian'' in perpetuity and to safeguard the journalistic freedom and liberal values of ''The Guardian'' free from commercial or political interference". The trust was converted into a limited company in 2008, with a constitution written so as to maintain for ''The Guardian'' the same protections as were built into the structure of the Scott Trust by its creators. Profits are reinvested in journalism rather than distributed to owners or shareholders. It is considered a newspaper of record in the UK. The editor-in-chief Katharine Viner succeeded Alan Rusbridger in 2015. Since 2018, the paper's main news ...
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Cephalopelvic Disproportion
Cephalopelvic disproportion exists when the capacity of the pelvis is inadequate to allow the fetus to negotiate the birth canal. This may be due to a small pelvis, a nongynecoid pelvic formation, a large fetus, an unfavorable orientation of the fetus, or a combination of these factors. Certain medical conditions may distort pelvic bones, such as rickets or a pelvic fracture, and lead to CPD. Transverse diagonal measurement has been proposed as a predictive method. Causes A large fetus can be one cause of CPD. A large fetus can be caused by gestational diabetes, postterm pregnancy, genetic factors, and multiparity. The shape of the pelvis can also be a cause of CPD. The pelvis may be too small, or the shape of the pelvis may be malformed. Shorter women are more likely to have CPD as are adolescents. Diagnosis Diagnosis of CPD may be made when there is failure to progress, but not all cases of prolonged labour are the result of CPD. Use of ultrasound to measure the size of t ...
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Caesarean Section
Caesarean section, also known as C-section or caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen, often performed because vaginal delivery would put the baby or mother at risk. Reasons for the operation include obstructed labor, twin pregnancy, high blood pressure in the mother, breech birth, and problems with the placenta or umbilical cord. A caesarean delivery may be performed based upon the shape of the mother's pelvis or history of a previous C-section. A trial of vaginal birth after C-section may be possible. The World Health Organization recommends that caesarean section be performed only when medically necessary. Most C-sections are performed without a medical reason, upon request by someone, usually the mother. A C-section typically takes 45 minutes to an hour. It may be done with a spinal block, where the woman is awake, or under general anesthesia. A urinary catheter is used to drain ...
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