92 Obstetrics and Gynecology Board Review •••
❍ List the risk factors for post-term pregnancy.
Primiparity.
Prior post-term delivery with increasing risk with each subsequent post-term delivery.
Fetal anencephaly.
X-Linked placental sulfatase deficiency.
Fetal male gender.
Prepregnancy BMI ≥25.
Adrenal hypoplasia.
Recurrence across generations.
❍ List the fetal risks associated with post-term pregnancy.
Increased perinatal mortality (approx twice the risk compared to term).
Uteroplacental insufficiency leading to oligohydramnios and intrauterine growth restriction.
Meconium aspiration.
Intrauterine infection.
Macrosomia.
Postmaturity syndrome.
Increased risk of death within 1 year of life.
Increased neonatal intensive care unit admissions.
Neonatal seizures.
❍ What is the cause of postmaturity syndrome?
Skin changes are due to loss of the protective effects of vernix caseosa.
Placental senescence and placental apoptosis.
Decreased fetal oxygenation as evident by increased cord blood erythropoietin levels in post-term pregnancy
Oligohydramnios.
Fetal growth restriction.
❍ What is the incidence of postmaturity syndrome in post-term pregnancy?
Approximately 10% between 41 and 43 weeks.
Increases to 33% at 44 weeks.
❍ Describe the appearance of the infant with dysmaturity syndrome.
Dry and wrinkled, parchment-like skin with desquamation.
Wasted, malnourished appearance with long, thin arms.
Meconium staining in some cases.
Long nails.
Sparse or absent lanugo.
Increased alertness with “wide-eyed” look.