Prolonged pregnancy: when should we intervene?

PURPOSE OF REVIEW: Prolonged (postterm) pregnancies are associated with both fetal and maternal complications. A variety of management practices can be utilized to mitigate the risk of these complications.

RECENT FINDINGS: In addition to routine induction of labor at 41 weeks, a number of alternative management strategies show promise in preventing adverse fetal outcomes. The routine use of ultrasonography for pregnancy dating lowers the rate of postterm pregnancy and is associated with less need for induction of labor. In the era of cervical ripening, routine induction of labor at 41 weeks does not increase the overall cesarean delivery rate.

SUMMARY: Prolonged (postterm) pregnancies, although less common in the era of ultrasound dating, are associated with fetal and maternal risks. The authors favor routine induction of labor at 41 weeks in women with low-risk singleton gestations.