Caughey Aaron B, Snegovskikh Victoria V, Norwitz Errol R
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, California 94143, USA.
Obstet Gynecol Surv. 2008 Nov;63(11):715-24. doi: 10.1097/OGX.0b013e318186a9c7.
Postterm pregnancy is defined as one which has progressed to 42 0/7 weeks or beyond. The most common reason to be diagnosed with a postterm pregnancy is inaccurate pregnancy dating, but it is also associated with obesity, nulliparity, and a prior history of postterm pregnancy. The rate of postterm pregnancy appears to be decreasing whether due to improved pregnancy dating or an increase in induction of labor. Postterm pregnancy is associated with both maternal and neonatal morbidity and fetal and neonatal mortality; similarly pregnancies beyond 41 weeks' gestation are associated with increases in these perinatal complications. Prevention of postterm pregnancies may include stripping or sweeping the membranes and unprotected coitus. Management of such pregnancies may include induction of labor and fetal antenatal monitoring. Individual patient management should involve careful counseling regarding the risks and benefits of each of the components of care.
Obstetricians & Gynecologists, Family Physicians.
After completion of this article, the reader should be able to recall the increasing risks of poor outcomes associated with prolonged pregnancy, demonstrate knowledge regarding gestational dating and use of cervical ripening agents in their care of pregnant women, and use evidence-based information when counseling their term patients regarding postterm pregnancy management.
过期妊娠定义为孕周达到或超过42 0/7周。诊断为过期妊娠最常见的原因是妊娠日期推算不准确，但它也与肥胖、初产以及既往有过期妊娠史有关。无论由于妊娠日期推算的改善还是引产率的增加，过期妊娠的发生率似乎都在下降。过期妊娠与孕产妇及新生儿发病率以及胎儿和新生儿死亡率相关；同样，妊娠超过41周也会增加这些围产期并发症的发生风险。预防过期妊娠可能包括人工破膜或剥膜以及无保护性交。此类妊娠的管理可能包括引产和胎儿产前监测。对个体患者的管理应包括就每种护理措施的风险和益处进行仔细的咨询。
妇产科医生、家庭医生。
阅读本文后，读者应能够回忆起与孕周延长相关的不良结局风险增加的情况，展示有关孕周推算以及在照顾孕妇时使用宫颈成熟剂的知识，并在就过期妊娠管理向足月患者咨询时使用循证信息。
