Академический Документы
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Культура Документы
2011
Dr K Waqanisau
O&G Dept
CWM Hospital
Introduction
Prolonged pregnancy
longer than 42 weeks /
Perinatal
Perinatal outcome
outcome
(40 weeks)
5 10% of all pregnancy will
Prevention
Prevention of
of post
post date
date
Induction
Induction vs
vs Expectant
Expectant
PERINATAL OUTCOME
Dating
Dating
Reduc
Reduc
ee PD
PD
Nipple
Nipple
Sweepi
Sweepi
ng
ng
Accurate Dating
USScan
CRL = 8 13 weeks +/- 5 days*
Biparietal diameter (BPD) = 12-20 weeks +/-
1 week,
BPD at 20-30 weeks +/- 2 weeks
BPD after 30 weeks +/-
3 weeks
Transcerebellar Diameter
The diameter in millimeters corresponds to weeks of
gestation up to 24 weeks.
parameters^
* - ALSO course syllabus 2000
2001
Sweeping Membrane
Theoretical Risks
Benefits
1. PROM
2. APH
in 7 hrs *
Decr synto
More NVD
Decr PT
3. Chorioamnionitis
Effective
. Nulliprious
Women
. Low Bishop Score
No trial on 1x or multiple
Most women find it very painful
^
NNT is 8 to avoid 1 IOL ^
Nipple stimulation
No evidence
INDUCTION VS EXPECTANT
Evidence
There was only 19 trials from RCT from
1969 2005
The Canadian multicentre post term
pregnancy 1992
They were all under powered in detecting
perinatal outcome
FETAL SURVEILLANCE
Types
Evidence
FKC
NST
CST
CCTG
BPP
Modified BPP
SUMMARY