What is prolonged pregnancy? – Prolonged is pregnancy that is more than 42 weeks since the last menstrual period, counting from the first day of the menstrual period. Most deliveries often occur between 37 and 42 weeks of pregnancy. Pregnancy within this range is term and ripe for delivery. Once it gets beyond this period, it is prolonged.

Why is pregnancy prolonged?

The reason why pregnancy gets prolonged is not too clear. However, the following reasons have been suggested as being responsible:

1. Inaccurate dating of pregnancy: This occurs when a pregnant woman is not sure or makes mistakes in date of her last menstrual period. It is the commonest reason why pregnancy may be thought to have been prolonged
2. First pregnancy
3. Previous history of prolonged pregnancy
4. Mother’s age above 35 years
5. Family history
6. Obesity
7. Male baby
8. Baby with abnormality
9. Hormonal imbalance
10. Problem with placenta

Why is there concern about prolonged pregnancy?

Prolonged pregnancy puts the life of both the mother and baby at higher risk; thus the concern.

What effect does prolonged pregnancy have on the baby?

When pregnancy goes beyond 42 weeks, it may have the following effects on the baby:

1. Big baby: The baby may be excessively big as it continues to grow while the pregnancy continues. This puts the baby at higher risks than normal-weight baby after delivery. It also has an impact on the mode of delivery, as well as complications to the mother during delivery.
2. Malnourished baby: The baby may appear old and malnourished due to inadequate nutrition it derives from ageing placenta.
3. Wrinkled skin: This reflects malnutrition; leading to reduction in skin turgor.
4. Overgrown nails: As growth continues, the finger nails become overgrown before delivery.
5. Breathing problem at birth: This may be due to aspiration of meconium (baby’s fecal matter before birth)
6. Admission into newborn unit: This may be due to breathing problems, low blood sugar (hypoglycaemia) or just for observation

What effect does prolonged pregnancy have on the mother?

Pregnancy that goes beyond the normal duration may affect the mother in the following ways: 

1. Psychological issues: The mother may become psychologically wearied carrying pregnancy for so long.
2. Increased risk of caesarean section: This may result from the baby being bigger than normal, not enough water around the baby to safely go through labour or placenta that cannot sustain the baby through labour.
3. Increased risk of injury to birth canal: This may result from giving birth to big baby.
4. Increased risk of bleeding after delivery: This may be due to giving birth to big baby which has over-distended the womb or following trauma to the birth canal.

How can prolonged pregnancy be prevented?

Prolonged pregnancy can be prevented by:

1. Accurate dating of pregnancy: This can be achieved by keeping menstrual calendar or doing ultrasound early in pregnancy.
2. Induction of labour for postdate pregnancy or caesarean section when indicated.
3. Membrane sweeping has been documented to help kick-start labour before it gets prolonged.
4. Having regular sexual intercourse at term has been documented to help kick-start labour in some women.