Prolonged pregnancy could lead to neonatal death – Expert 

Dr Victor Fayomi, a General Medical Practitioner with a private hospital in Abuja, has warned that prolonged pregnancy could increase the risk of stillbirth and neonatal death, if not properly managed.
Fayomi told the News Agency of Nigeria on Friday in Abuja that both mother and baby have their share of possible health risks.
According to him, once a woman carries her pregnancy to 42 completed weeks, the pregnancy is termed a prolonged pregnancy.
He said: “Pregnancy is said to be `term’ between the gestational age of 37 to 42 weeks. It is considered early term at 37 weeks, full term at about 39 weeks and late term at 41 weeks.
“Other things being equal, the joy that comes with carrying a pregnancy to term is having a baby who is naturally endowed to live life outside the comfort of the womb without much challenge.
“With five to 10 per cent of pregnancies ending up being prolonged, it suffices to say that the cause is unknown. However, a number of risk factors have been associated with it.”
Fayomi further said that once a pregnancy was prolonged, there could be decrease in blood flow to the placenta causing placental insufficiency.
He said the baby may pass meconium (baby’s first stools, usually greenish or black) in the womb which the baby may aspirate it into the lungs.
Fayomi added that there could also be an increase in the incidence of birth injuries to the baby, prolonged labour, foetal malnutrition and intrauterine growth retardation.
He said that the mother was prone to increased psychological stress and anxiety, obstructed labour, trauma to her genitals, instrumental vaginal delivery, postpartum haemorrhage and infection.
He said: “Preterm pregnancies births (premature babies) have their array of health challenges.
“Babies delivered following prolonged pregnancies also have a number of health risks to battle with. Women who carry prolonged pregnancies are also faced with some risks to their health too.
“The causes of prolonged pregnancy can be associated with high maternal weight or body mass index, advanced maternal age (pregnant women above 35 years) and mother being a baby born from a prolonged pregnancy herself.”
Fayomi said babies usually have lower than normal amount of subcutaneous fat which often makes the skin wrinkle, adding that skin may be loose, flaky and dry.
He said that a decreased foetal movement could be noticed before delivery and also reduction in uterine size due to reduced amniotic fluid volume.
Fayomi however advised expectant mothers between 40 to 41 weeks of pregnancy to ensure they were properly monitored by a doctor.
He said: “It is usually done through foetal movement monitoring with the use of a ‘kick chart’ which the woman is also taught how to use.’’
He listed other methods for monitoring as electronic foetal monitoring, obstetric scan for measurement of amniotic fluid volume, biophysical profile and doppler flow study.
Fayomi said: “From 41 completed weeks, the maternal and foetal risks commence, these with other factors like findings from foetal monitoring, past obstetric history, the obstetrician’s clinical judgment will come into play.
“These will counsel and prepare an expectant mother for her baby’s delivery.
“The first approach is for an `induction of labour’, and where and when indicated, a Ceaserean section.”
Fayomi also advised women who experience prolonged pregnancy to avoid traditional methods.