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A post-term or prolonged pregnancy is one that reaches 42 weeks' gestation; approximately 5 to 10 percent of pregnancies are post-term. Studies have shown a reduction in the number of pregnancies considered post-term when early ultrasound dating is performed. Maternal and fetal risks increase with gestational age, but the management of otherwise low-risk prolonged pregnancies is controversial. Antenatal surveillance with fetal kick counts, nonstress testing, amniotic fluid index measurement, and biophysical profiles is used, although no data show that monitoring improves outcomes. Studies show a reduction in the rate of cesarean deliveries and possibly in neonatal mortality with a policy of routine labor induction at 41 weeks' gestation.
Approximately 5 to 10 percent of all pregnancies continue to at least 42 weeks' gestation.Advances in obstetric and neonatal care have lowered the absolute mortality risk; however, retrospective studies1 of these so-called post-term pregnancies have found an increased risk to the mother and fetus. The perinatal mortality rate (i.e., stillbirths plus neonatal deaths) of two to three deaths per 1,000 deliveries at 40 weeks' gestation approximately doubles by 42 weeks and is four to six times greater at 44 weeks.
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