Cases are not uncommon when the expectant mother has already set up for childbirth, the waiting time has expired, and the baby does not think to be born. Why is that? What is this connected with and does such a prolonged expectation pose a danger to mother and child? Let's see when a pregnancy is considered to be postponed?
Belated pregnancy - what is it?
40 weeks is the average pregnancy rate from the beginning of conception to the time of birth. But this does not mean that all women in labor must wait for the baby to appear in this period. Many give birth at 36-38 weeks, and the child is absolutely healthy. Situations are also possible when a completely full-fledged newborn is born at 40-42 weeks. Then, what pregnancy is considered postponed?
Do not panic if you have already begun 41 weeks of pregnancy, and there are no harbingers of early birth. Doctors evaluate not so much the terms of a postponed pregnancy as the condition of the placenta, water and the baby itself. If everything is in order, then at the onset of 42 weeks, biological tolerance is diagnosed. And before that, from the 40th to the 42nd week there comes a period of "potential" portability. The "protracted" women in labor are taken under special control, monitoring regularly the placental state.
What are the reasons?
Postponed pregnancy is an infrequent phenomenon. Of 100% of women in labor, only 8% are at risk. And to late delivery certain factors provocateurs lead. Why are pregnancy being delayed?
The main reason is hormonal imbalance, in which case the hormones responsible for labor are drastically reduced in quantity. Hormones in the perinatal period are very unstable, therefore they are constantly monitored and monitored by doctors.
In addition, there are a number of other reasons for a postponed pregnancy:
- hereditary predisposition;
- late pregnancy, when the age of the woman in labor is more than 35 years;
- the onset of toxicosis in recent weeks;
- inflammation in the ovaries;
- endocrine disorders;
- uterine fibroids;
- repeated abortions performed earlier;
- infectious diseases transferred during the period of bearing a child;
- large size of the fetus or its pelvic presentation;
- reproductive system dysfunction;
- fetal pathology (hydrocephalus, genetic diseases, adrenal gland dysfunction);
- frequent stress;
- inactive lifestyle during gestation.
Bearing a child should be accompanied by precautions, since the body of the expectant mother is vulnerable and very susceptible to infection and the development of diseases.
Who is at risk?
Postponed pregnancy can happen in many women in childbirth, but there is a category of women who are at greater risk. These include:
- "Old-born" women whose age exceeds 35 years. Particularly high probability for those who give birth for the first time.
- Those who have pelvic presentation of the fetus in the last weeks of pregnancy.
- Ovarian diseases associated with impaired functionality or structural changes.
- The presence of chronic diseases.
Experts strongly recommend that expectant mothers lead a healthy, active lifestyle, unless of course there is a threat of miscarriage. This will not only significantly reduce the risk of overexposure, but also facilitate the birth process.
Signs
When the period of postponed pregnancy comes, then it is possible to diagnose this period by the accompanying symptoms. They appear both externally and internally. These include:
- birth weight loss by 1-5 kg;
- a decrease in the volume of the abdomen by 5-10 cm;
- decreased tonus of the skin of the abdomen;
- frequent uterine tone, hypertonicity is possible when the uterus most of the time is in a compacted, even solid state;
- fetal asphyxiation, when the fetus lacks oxygen, its movements decrease activity, heart rhythms are reduced or, on the contrary, become more frequent, the bones of the skull are densified;
- the allocation of milk from the breast, namely milk, and not transparent colostrum;
- darkening of placental waters;
- aging of the placenta.
The listed symptoms occur after 10 days from the preliminary date of birth. Their appearance allows you to put a pregnant woman at risk and radically change the tactics of tracking her pregnancy.
Diagnostics
Most often, to confirm the presence of a postponed pregnancy, based on the timing. That is, they calculate the estimated date of birth, counting the time from the last menstrual flow, determine the duration of the cycle.
But, they also examine the condition of the uterus, amniotic fluid and conduct an ultrasound scan. Diagnosis of a postponed pregnancy is necessary mainly in order to assess the condition of the fetus, because this phenomenon can affect it very, very unfavorably.
What does the diagnosis include?
- Obstetric examination consists in measuring the volume of the abdomen, assessing the weight gain of the woman in labor, and monitoring the child’s motor processes. The baby’s heartbeat is heard, and the uterus is palpated to assess its condition.
- Examination on a gynecological chair. With its help, the stage of maturation of the placenta, the state of the cervix, whether it is opening, the location of the fetus, and also the density of the bones of the skull of the fetus are established.
- CT method (cardiotocography), which sets the frequency of uterine contractions, and also tracks the work of the child’s cardiac system.
- Doppler study. With its help, the state of blood circulation in the uterus and placenta is assessed.
- Amniocentesis is a method that allows you to assess the state of amniotic fluid by removing some of them from the placental sac.
As soon as the results of the examinations are unfavorable, doctors decide on an immediate change in the tactics of labor management, but most often resort to an early delivery.
Consequences of a postponed pregnancy for a woman in labor
This phenomenon is quite serious and can adversely affect the state of the woman in labor and the condition of the child.
For a woman, this can threaten the following:
- a sharp drop in pressure;
- heavy bleeding;
- surgical intervention in the form of a caesarean section.
- a long rehabilitation period after delivery.
How does this threaten the child?
With a postponed pregnancy, the child suffers more than the mother. Firstly, this is the development of hypoxia, that is, a lack of oxygen. This leads to the fact that the baby can take his first breath while still in the placental sac, while swallowing amniotic fluid. In the waters, meconium (the first emptying of the intestines of the fetus) may be present and the child can swallow it. After the birth of the baby, emergency lung ventilation is performed.
A postponed pregnancy can contribute to the fact that the child, due to active movement, wraps around the umbilical cord, pulling his neck.
Birth trauma is also possible with a late birth. The thing is that the cranial bones of the child cease to overlap, become denser, making it difficult for the fetus to exit through the birth canal.
Postponed babies after birth experience sleep disturbance, are often capricious and tearful, spit up heavily after each meal, and accordingly gain weight slowly and outwardly lag behind in development.
Children born in the later stages may be jaundiced. Oxygen starvation can trigger the release of large amounts of bilirubin into the blood. A newborn is born with a cover of skin, sclera and mucous membranes of yellow color. Jaundice can occur in any child, even in an unsupported child. Normally, it lasts a week and does not require any kind of treatment. But in a "belated" child, such a disease can develop into a pathology and will require prolonged monitoring by a pediatrician and treatment.
Differences of the transferred child
A child who has “delayed” his birth for more than 10 days is born-over. A logical question is formed from this: is such a child different from the one born on time?
Yes, some features in appearance such children have:
- too wrinkled skin, which, moreover, is thin;
- regrown hair or long nails;
- dense bones, fused fontanel on the head;
- body length 56-57 cm, large head.
The appearance of a newborn baby who has been postponed may differ depending on what degree of portability he has. There are 3 degrees:
- It occurs at 41 weeks of gestation. The condition and behavior of such a baby is not much different from "timely" children. But, nevertheless, some changes are observed: the skin is drier, the body length is more by a couple of centimeters, the activity is slightly higher.
- It occurs for 42 weeks and lasts up to 43. In such children, a violation in the respiratory system occurs. Inhalation and exhalation occurs with some difficulty, convulsions are not uncommon. Their growth is 2-3 centimeters above normal.
- The latest and rare, comes from 44 weeks. To this extent, doctors, as a rule, do not drag out the situation. But, if this still happened, then it is highly likely that the child will either be born dead or not live a day. If, nevertheless, the baby survives, then his condition is assessed as critical. He quickly loses weight, eats poorly, has difficulty breathing. Such children need regular supervision for 1-2 months.
The birth process. What is changing?
The consequences of a postponed pregnancy are always negative for the state of the mother and baby. Therefore, if a woman in labor had previously had this phenomenon, then from the first days of pregnancy she is considered a risk group for overeating. And for a period of 40-41 weeks she is hospitalized.
Very often, natural delivery is replaced by caesarean section. It is inevitable for a woman if:
- she has a narrow pelvis;
- unripened cervix;
- the water has departed, and the opening of the cervix does not occur for a long time;
- pelvic presentation of the fetus is observed;
- past birth ended in the death of the child;
- the fetus is tightly entwined with an umbilical cord;
- overripe placenta;
- the presence of postoperative scars on the uterus, whose age is less than 3 years.
Cesarean is not the only option of delivery. If there is no indication for it, then the process will take place in a natural way. But he is called artificially. Of course, a number of preparatory measures are carried out in advance so that the delivery can take place without complications.
- Prescribe medications whose action is aimed at improving blood circulation in the uterus and placenta. Uterus massage is also prescribed.
- Soften the cervix, since its timely opening is the key to successful delivery. For this, prostaglandins are prescribed.
- Prescribe the intake of "Mifepristone" - a drug that blocks the production of progesterone. This medication is used as emergency contraception in the first few hours after unprotected intercourse. And also it is often prescribed for medical termination of pregnancy. But, do not be afraid of its effects during pregnancy. "Mifepristone" causes uterine contractions, leads to cervical dilatation, thereby provoking labor. It is prescribed if there are no contraindications to natural delivery.
Is there any prevention?
From a postponed pregnancy, the consequences for the baby can be unfavorable, so every expectant mother wants to protect her baby from this fate. But it is impossible to predict this phenomenon only if the woman in labor had already had an overtightening, or if one of the next of kin had it.
For such women in labor, there are a number of preventive measures that will help reduce the risk of a postponed pregnancy. These include:
- monitoring the state of the endocrine system and timely treatment;
- monitoring the status of the pelvic organs;
- responsible approach to pregnancy planning, elimination of unwanted pregnancy through contraception, not abortion;
- the birth of the firstborn to 35 years;
- appeal to a gynecologist and pregnancy management in the first trimester up to 12 weeks;
- refusal of bad habits during planning and during bearing a child;
- the use of exclusively healthy, balanced food, with a large presence of fruits, vegetables and protein;
- visiting a doctor who is conducting pregnancy regularly, as well as passing tests and passing diagnostic methods;
- sparing physical activity. These include group exercises for pregnant women, which are held in fitness clubs. Walking in the fresh air, lasting at least an hour with average slow walking, is also very useful.
The presented list of actions is useful for every expectant mother, and most importantly for the unborn child.
Prolonged pregnancy
Postponed and prolonged pregnancy - the concepts are somewhat different. Prolonged is included in the concept of "normal pregnancy" and does not bear negative consequences for the baby's health.
And prolonged and postponed births are all varieties of late delivery, but the latter are also called overripe.
Finally
Not a single woman is safe from a postponed pregnancy, but for some it is still possible to predict the likelihood of her occurrence. You should not be afraid of it, and most importantly, visit your gynecologist on time and not interfere with him, if necessary, change treatment tactics. Indeed, portability is a huge test for the body of a newborn, which can lead to adverse consequences for its health.