When the pregnancy exceeds 41 weeks of amenorrhea (SA), it is said to be prolonged. The term is passed when the duration of pregnancy exceeds 42 weeks. As prolongation of pregnancy is associated with risks of complications, if you have not given birth on the day of term, monitoring is carried out and delivery can be initiated.

A full term pregnancy corresponds to 41 weeks of amenorrhea (SA) or 49 weeks of pregnancy. Once this period has passed, a pregnancy is said to be prolonged, entry 41 and 42 WA. If the delivery does not take place at 42 weeks, the term has passed. In France, 15 to 20% of women have a prolonged pregnancy. The outdated term concerns only 1% of pregnancies.

Why do some women go beyond the term of their pregnancy? Family, hereditary and ethnic factors come into play.

• The risk factors for exceeding the term found in the studies?
• Personal and family history of exceeding the term
• Nulliparity (first child)
• Maternal age
• Ethnic origin
• Weight (obesity favors going over the term)

Prolonged pregnancies present an increased risk of fetal mortality and morbidity. The risk of perinatal mortality thus drops from 0,7% to 5,8% from 37WR +6 days to 43WR + 6 days. The fetus indeed presents an increased risk of oligoamnios (lack of amniotic fluid), abnormalities of the fetal heartbeat, emission of meconium in utero. Oligoamnios affects 10 to 15% of prolonged pregnancies.

Newborns born after term have an increased risk of neurological complications, disorders of psychomotor development, cerebral palsy, etc.

Prolonged pregnancies also present risks of maternal complications.

Close monitoring is performed from 41NW when a woman has not given birth by that date. Examinations carried out 2 to 3 times a week? A clinical examination, a monitoring in order to monitor the fetal heart rate and thus to be able to detect a possible fetal suffering, an ultrasound to check the dimensions of the baby, the quantity of amniotic fluid, the quality of the placenta.

If the delivery has not taken place at 41NT + 6d, it is initiated.

In the absence of pathology, an induction is offered to mothers-to-be between 41 + 0 WA and 41 6 days SA.

The timing is determined according to maternal characteristics (condition of the cervix, uterine scar, age, weight, etc.), the mother’s preferences and the organization of maternity care.

There are several methods of triggering:

• Detachment of membranes
• Oxytocin injection
• Prostaglandin buffer or gel
• Mechanical means (Foley probe)

The method chosen depends on the condition of the cervix. Thus, the use of prostaglandins can be done with a favorable or unfavorable cervix.

The newborn who is born after term and has inspired meconium fluid can undergo aspiration, intubation, ventilation with a mask, etc.