Post-term pregnancy: fetal death rate with antepartum surveillance.

Management of the post-term pregnancy depends on the certainty of dating, likelihood of successful induction, and risks of expectant management. To estimate the risk of fetal death in an expectantly managed post-term population, we reviewed 8038 consecutive post-term gestations followed expectantly with a twice-weekly nonstress test and amniotic fluid index. There were nine antepartum fetal deaths and no intrapartum fetal deaths, a fetal mortality rate of 1.12 per 1000. Timing of delivery of the post-term gestation balances this risk of loss of a viable fetus with the risks of uncertain dating and failure of induction of labor.