Level C recommendations

• Despite a lack of evidence that monitoring improves perinatal outcome, it is reasonable to initiate antenatal surveillance of post-term pregnancies between 41 weeks and 42 weeks' of gestation because of evidence that perinatal morbidity and mortality increase as gestational age advances.

• Many practitioners use twice weekly testing with some evaluation of amniotic fluid volume beginning at 41 weeks' of gestation. A non-stress test and amniotic fluid volume (a modified biophysical profile (BPP)) should be adequate.

• Many authorities recommend prompt delivery in a post-term patient with a favourable cervix and no other complications.

The SOGC guidelines provoked an impassioned response [81]. The authors challenged the evidence of increased morbidity and mortality as pregnancy advances and the evidence from the randomized trials that induction of labour post-term does not increase Caesarean section rates and may reduce perinatal mortality rates. In particular, they were concerned that the recommendation from SOGC and RCOG that induction should be 'offered' at 41 weeks' gestation would be interpreted as a policy of mandatory induction at 41 weeks' gestation.

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Getting Back Into Shape After The Pregnancy

Getting Back Into Shape After The Pregnancy

Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.

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