••• Chapter 9^ Postdates Pregnancy and Fetal Demise^93
❍ What intrapartum and neonatal complications are observed in the infant with postmature syndrome?
Intrapartum: Umbilical cord compression from oligohydramnios.
Meconium aspiration.
Nonreassuring fetal heart tracing.
Neonatal: Hypoglycemia.
Seizures.
Respiratory insufficiency.
❍ What fetal heart rate tracing patterns are concerning for oligohydramnios leading to intrapartum fetal
distress in post-term pregnancies?
Prolonged decelerations.
Variable decelerations.
Saltatory baseline (oscillations exceeding 20 bpm).
❍ List the maternal complications associated with post-term pregnancy.
Labor dystocia.
Perineal injury.
Cesarean delivery.
These complications are due to the higher risk of macrosomia.
❍ What maternal complications are seen with higher frequency following cesarean section versus vaginal
delivery?
Endometritis.
Hemorrhage.
Thromboembolism.
❍ What form of antenatal surveillance may be used to assess the post-term fetus?
Options include: Nonstress test.
Biophysical profile.
Modified biophysical profile.
Contraction stress test.
No single method has been shown to be superior, but an assessment of amniotic fluid volume should be
incorporated into the surveillance scheme.
❍ What are the components of the biophysical profile?
Nonstress test with ultrasound assessment of gross fetal body movements, fetal tone, fetal breathing, and amniotic
fluid volume.
❍ What is the modified biophysical profile?
Nonstress test plus amniotic fluid volume estimation.