A chronologically extended pregnancy is a pregnancy that exceeds the normal period of pregnancy without labour beginning. It is believed that prolonged pregnancy is chronologically extended after 40 weeks or 280 days from the beginning of the last menstrual period.
The extended pregnancy is a risk for both the mother and the foetus, but modern medicine makes these risks be much more reduced. However, up to 42 weeks of pregnancy, the risk is small (many pregnancies get to 42 weeks without negative consequences). In general, when one considers that pregnancy is prolonged and at risk, artificial methods of medical labour are used.
What causes a prolonged pregnancy?
A chronologically prolonged pregnancy can be caused by the mother or foetus:
• Mother. Certain genetic factors, diabetes, heart disease and chronic liver or a poor care of the future mother during pregnancy, an unbalanced diet, uterine malformations or even the women’s stress can cause a prolonged pregnancy. Often, women having their first pregnancy or who have given birth many times (5-6), very young women or who are too old may face a prolonged pregnancy.
• Foetus. Some foetal malformations can cause a prolonged pregnancy, but also a great weight of the foetus (over 4 kg).
Risks involved in a prolonged pregnancy:
• Aging placenta. The placenta supplies the foetus with oxygen and nutrients, but after a time it cannot work properly as it can age, thus causing the lack of vital substances and even foetal asphyxia, unless a timely intervention is schedules.
• Lack of development syndrome. After 42 weeks, the foetus is fully developed and stops growing, but the lack of development syndrome can occur, a kind of involution of the foetus –reduced fat coating, dry skin.
• Artificial induction of labour. Risks are also related to the medical induction of labour – uterine rupture, long and painful labour, necessary interventions to extract the foetus with the forceps.
Interventions in a prolonged pregnancy:
• Weeks 40-42. During these weeks, the risk is considered to be minimal. It is necessary to consult your doctor and look for signs of labour and alsocheck the position, size and the heart beats of the baby. From week 40 onwards, the pregnant woman should be under medical supervision.
• At wait. For about 80% of the extended pregnancies over 40 weeks end, however, with natural labour, doctors may recommend waiting, but with frequent monitoring of the foetus. During this waiting period, it is recommended that the woman rests, relaxes and tries to walk – but near the house (if bed rest is not necessary).
• Sex. If a pregnant woman does not have problems, by week 43, doctors may recommend sex as a natural way to induce labour – especially the state of arousal and orgasm relax the body and cause the secretion of oxytocin (oxt – meaning “quick birth”) – substance secreted during labour. Additionally, semen contains prostaglandins, which soften the cervix. Nipple stimulation causes the release of oxytocin, too.
• When is an artificial induction of labour necessary? An artificial induction of labour is advisable only after week 43 of pregnancy in general. It is also recommended if the amniotic fluid is not enough, the foetus weighs too much, you can see signs of foetal distress or the mother has high blood pressure. The artificial induction is adopted also if the water breaks, but contractions do not begin.
• How to make the artificial induction of labour? In general, doctors administer intravenous Pitocin (oxytocin in the synthetic form) or use a prostaglandin gel. Pitocin causes very strong and painful contractions, which may even affect the foetus or cause uterine rupture. During artificial induction, permanent electronic foetal monitoring is essential. Labour will be extremely painful or prolonged – it can end up with caesarean delivery if the baby shows signs of distress or if the mother is too exhausted.