Pregnancy: I have passed the term, is it serious?

How do you calculate the term of childbirth?

No need for scholarly calculations to determine our delivery date !

There are two separate reference dates for calculating the duration of pregnancy. We must therefore not confuse:

– counts in days or weeks of amenorrhea, that is to say from the 1st day of the last menstruation, easy to know;

– counts in days or weeks of actual pregnancy, that is to say from the date of presumed fertilization, at the beginning of the 3rd week of amenorrhea.

Doctors consider that the duration of a normal pregnancy is 40 completed weeks of amenorrhea (absence of periods) or 41 weeks since the first day of the last period. But since menstrual cycles can be irregular, the doctor confirms the date of the onset of pregnancy with an ultrasound.

Pregnancy is generally considered to last: 280 days of amenorrhea or 266 days of pregnancy. Although the second number represents the actual age of the baby, it is the first, more reliable, that serves as the international standard for all data concerning pregnancy.

To calculate the theoretical date of delivery, the doctor also takes into account the measurements of the fetus taken during the first ultrasound (at 12 weeks of amenorrhea). The length of the fetus (from the head to the buttocks) in particular is a good indicator to determine its “age”, to within four days. However, if at the end of the 41st week of amenorrhea, the baby is still not there, we are in overdue.

When do we speak of term overrun?

41st week of amenorrhea, and the baby is still not here… In medical terms, we are talking about overdue. This happens in 3% of cases. It is difficult to calculate the exact date of term. Pregnancy does not have a fixed duration, but a statistical average duration of 266 to 273 days from conception, and 280 to 287 days from the date of the last period. Doctors consider that the duration of a normal pregnancy is therefore 40 completed weeks of amenorrhea (or 40 weeks). Exceeding the term begins from the 41st week of amenorrhea.

Exceeding term: what is the risk for the mother and the baby?

Going beyond the term can pose delicate problems. the placenta, a veritable factory of exchanges between mother and child, provides food until the end of the day and above all the oxygen essential to the fetus. Beyond that, this organ begins to age and functions less well. The contributions of the fetus become insufficient. There is a risk of fetal distress.

Exceeding the term: what medical follow-up?

Le overdue involves a reinforced medical follow-up at the end of the pregnancy: the obstetrician-gynecologist or midwife will examine us every other day, or even every day, to make sure that we and our baby are well. It’s not a pleasant time: we can’t wait to get to know our baby, and we have to go to the hospital every day, without knowing exactly when the birth will finally take place.

Cool … we take our troubles patiently. Exceeding the term is not that rare, especially if it is a first pregnancy. And no stress: in truth, the situation becomes worrying only if the pregnancy is prolonged beyond 42 weeks of amenorrhea.

Term expired: cervical examination, monitoring and amnioscopy required

On a practical level, the midwife will examine the cervix, take the tension and measure the fundal height with a seamstress’s tape to assess the volume of the fetus. Following this examination, we will have to make a monitoring. It is a kind of belt placed on our stomach, connected to a machine which records the heart variations of the fetus as well as our contractions. Fetal monitoring helps to monitor the baby’s good health. This exam lasts a good half an hour. If there’s nothing to report, we’ll go home. Doctors usually prefer the pregnancy to continue for a few days, while waiting for labor to start spontaneously.

In case of doubt, the doctor can also do additional examinations. Ultrasound may show a decrease in the volume of amniotic fluid, indicating the onset offetal hypoxia (lack of oxygen). A amnioscopie sometimes supplements this monitoring: a transparent plastic tube is introduced into the opening of the cervix in contact with the amniotic membranes (water bag), in order to observe the color of amniotic fluid. If it is clear, then all is well. Otherwise, the fetus suffers. Direction delivery.

When will the childbirth be started?

The doctor can make the decision to induce childbirth : if the fetus has still not expressed its desire to go out at the end of the 41st week, or if the amnioscopy indicates that the child is in pain. We reassure ourselves, late babies are generally healthy. They just have peeling skin and long fingernails!

How do you initiate childbirth?

• Spontaneous triggering

If we still have not given birth in the 41st week of gestation, the doctor will probably suggest that we set a date to induce birth. This is often enough for labor to begin spontaneously the day before, or in the hours preceding this date. For others, childbirth will be triggered with medication.

• Drug triggering

If the cervix is ​​favorable, that is to say short, flexible and centered, the mother is placed under an oxytocin infusion, a hormone that causes contractions within 30 minutes. Epidural anesthesia is usually done to make labor flow easier and to relieve the mother of contractions, which are particularly intense with these drugs. If the cervix is ​​not ready for delivery, it must first be ripened using locally placed prostaglandins in ovum or gel. Only then does the midwife put in the oxytocin infusion.

How to react if the term is exceeded?

We can ask ourselves the question: do we want to keep our baby warm a little longer, or out of fear of suffering during childbirth? We do not hesitate to talk about it with our spouse and with the midwife who follows us. We can also talk to our baby. He plays an active part in his birth. So, we put our hands on our stomach, we stroke it and we talk to it: ” It’s time, my darling, everyone is waiting for you, we can’t wait to meet you, you’ll see what we can do together! “. We walk, we clean, we carry our groceries, we play on all fours with our children, anything goes! And if our partner wants to make love, we do not deprive ourselves of this moment of happiness: it seems that this can accelerate the onset of labor – it is the famous “Italian trigger!