1、单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Postterm pregnancy,Definition,Prolonged pregnancy,post-dated pregnancy,Pregnancy that has reached 42 weeks(294 days)of completed gestation from the first day of the last menstruation or 40 weeks,gestation from the time of conception,Menstrual cycle is normal 2830 days,The frequency of postpartum pregnancy is 510%,Etiology,Unclearly,maybe correlate to fetal adrenal cortex,Surmise the mechanism for the initiation of parturition has some abnormalities,PG
2、and E deficient,P increase,Placental sulfatase deficiency,sex-linked recessive inheritance,in male,E,Fetal malformation,Anencephalic fetus,hypoplasia of adrenals,Physiology,Placental function is sufficient,Fetus growth,macrosomia,shoulder dystocia,Skull calcified,Placental function is insufficient,Three stage,Postmaturity syndrome(PMS):infants are withered,meconium-stained,fragile,with long nails and peeling skin,Placenta:thinner,infarcts,fibrin deposition and calcification,Complication,Perinata
3、l morbidity rates increased sharply,Fetal distress,meconium aspiration syndrome(MAS),asphyxia,Trauma:shoulder dystocia,Mental retardation and neurologic sequelae,Mother:,manipulative delivery is increased,Diagnosis and Treatment,Dating the pregnancy again,Date the LMP,Positive Serum HCG at 5 weeks,urine HCG,Fetal heart tones auscultated with a stethoscope at 1820 weeks,with electronic device in 10 weeks,Physical exam of uterus:height of fundus,bimanual,Maternal perception of quickening,Ultrasoun
4、d,:crown-rump length,diameter of BPD,2.Evaluation of the fetus,Normal fetal movement,10beats/12h,Electronic fetal monitoring:NST,CST,23 times weekly,Ultrasound evaluation(biophysical profile),4 abnormal,Ultrasound measurement of the amount of amnionic fluid:AFI(amnionic fluid index)8 in normal,4000g or FGR,Other severe complication:eclampsia,oligohydramnions,Diagnosis and Treatment,Vaginal delivery,Cervical ripen:artificial rupture of fetal membrane,Cervical unfavorable:use medicine to make it r
5、ipen,Cesarean section,Cervix is unfavorable,Inducing labor is failed,Fetal distress,Dystocia:fetopelvic disproportion,Diagnosis and Treatment,Summary,Gestation 42 weeks,Fetal movement,Amnionic,fluid,Biophysical,profile6,CST,positive,NST nonreactive,CS,Induced Vaginal,delivery,AFI5,See you next time!,BPD diameter,Thorax diameter,Abdomen diameter,femur,Amnionic fluid,Placenta,Early stage,Dry parchment like skin,wrinkling and peeling,Long finger nails,Thin,long infant,Intermediate stage,Meconium stained membrane,placenta and fetal skin,Advanced stage,Amniotic fluid,placenta,membrane and fetal skin markedly stained,yellow,wizened old look,Oligohydramnion:cord compromise,
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