Pregnancy: What to Expect When You're Past Your Due Date
Pregnancy is really an awesome experience; it is considered the most valuable gift a female has been blessed with. Pregnancy is a beautiful transition, which has the greatest and deepest impact on anyone’s life. The normal term/period of pregnancy is around 38-42 weeks from the first day of women’s last menstruation. The due date of pregnancy is medically called as “Estimated Date of Confinement (EDC)”. This EDC can be calculated if the first day of last menstrual cycle is known. If the baby is born before 37 weeks, the pregnancy is called as pre-term delivery and the pregnancy that has crossed the due date where the baby has not born even after 42 weeks it is called as overdue pregnancy. Overdue pregnancy is also called as “post-term pregnancy”, “prolonged pregnancy” or “post date pregnancy”. It is estimated that 5 in every 100 women (5%) have post-term delivery.
Calculating due date
The due date or EDC is calculated based on the first day of the last menstrual cycle, and also on the size of uterus during early pregnancy. An ultrasound scanning will also help the physician to know how far the pregnancy has progressed and how long to wait more. A very effective way is just counting the next 40 weeks from the first day of last menstrual cycle. But many women do not remember their day-1 of last menstrual cycle. And if a women gets pregnant immediately after stopping birth control pill, then it is very difficult to calculate the exact due date.
Complications of overdue pregnancy
Many complications can result if pregnancy is overdue. If the pregnancy extends for a week after the EDC, then the physician starts monitoring the baby very closely. First of all, the heart beat of the baby will be checked once or twice every week using an electronic fetal monitor. An ultra sound examination will be done to check the amniotic fluid surrounding the baby and also the movement of the baby in the womb. The mother should continuously feel the movement of the baby throughout the pregnancy. The cervix will also be examined to see whether it is dilated and thin. The physician might also recommend inducing labor.
If pregnancy is overdue by 2 weeks labor is induced to avoid complications like large baby that is hard to deliver, fetal distress (when there is less oxygen for the baby), drop in baby’s heartbeat, and finally death due to intolerance of stress during labor. Long term pregnancy also compromises the ability of the baby to survive as the placenta ages and fails to deliver oxygen and nutrients to the fetus. An overdue baby is more likely to drink fecal waste (meconium) during delivery, which results in difficulty breathing and infection of the lung after birth. The baby may also face Macrosomia (large body size), shoulder dystocia (the shoulder of the fetus is stuck and further delivery is prevented), and brachial plexus injury (network of nerves located in the neck and axilla). As the baby grows bigger the chance of normal birth decreases and a cesarean is inevitable. The risk of infection, vaginal trauma, post-partum hemorrhage increases for the mother.
Inducing labor
Nature is the master of all functions, and it also controls the many aspects of pregnancy but in some cases it requires triggering agent. If the physician feels that the baby and mother would be fine if the baby is delivered early than waiting anymore, the physician might decide to induce labor. Labor is induced by intravenous injection of Oxytocin (a hormone that induced contraction of the uterus). It usually takes 2-3 hours for the hormone to start working. In some, labor can be induced by puncturing the amniotic sac that holds the amniotic fluid and the baby. This procedure does not pain but the leakage of water can be felt. In many women, breast stimulation or massaging the breast may release the hormone oxytocin, but in such cases the cervix should open and be ready for delivery. A vaginal prostaglandin gel is used to dilate the cervix.
Conclusion
Post-term delivery, in many, gives a normal and a good outcome despite of the complications associated. In very few people the risk of perinatal death and fetal convulsion (involuntary muscle contraction that results in contortion of the limb and arm) takes place. When the patient and the physician have the facility of reliable pregnancy ultrasound this should be used to closely follow the pregnancy and avoid unnecessary confusions in the due date. Monitoring the fetal development is very important to avoid further future complications.
