Prolonged Pregnancy (Postterm Pregnancy) Nursing Management

Description
  1. A prolonged or postdate pregnancy is a pregnancy that extends past 42 weeks’ gestation.
  2. The incidence of prolonged pregnancy is approximately 10%.
Etiology
  • The actual physiologic cause of prolonged pregnancy is unknown. A suggested etiology is estrogen deficiency.
Pathophysiology
  • Pathophysiology includes excessively large infants with resultant birth trauma or small-for-gestational-age infants who are deprived of hydration and nutrition, because of placental aging and dysfunction and decreased amniotic fluid.
Assessment Findings

1. Clinical manifestations

  • Weight loss and decreased uterine size (when the infant is suffering from placental dysfunction)
  • Excessively large uterus
  • Meconium-stained fluid
  • Nonreassuring fetal heart rate patterns

2. Laboratory and diagnostic study findings. Ultrasound examination may be used to assist in determination of fetal size.

Nursing Management

1. Carefully assess the fetus to identify risk.

  1. Perform a careful risk assessment upon admission.
  2. Closely monitor fetal status.

2. Prevent birth complications.

  1. Assist with induction of labor
  2. Prepare for a difficult delivery
  3. Notify the pediatric staff of the potential for a birth-injured baby.

3. Provide physical and emotional support.

4. Provide client and family education.

 

 

 

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