Post term pregnancy power point presentation

A postterm pregnancy is a pregnancy that lasts more than 42 weeks, or 294 days, from the first day of the last menstrual period (LMP). This is two weeks past the typical 40-week duration of pregnancy.

Postterm pregnancies can carry risks for both the mother and the baby, including: Fetal malnutrition, Meconium aspiration syndrome, Stillbirths, and Increased perinatal mortality rate.

However, most postterm babies are born healthy.

Some factors that can increase the chance of a postterm pregnancy include:
Being a first-time mother
Having had a postterm pregnancy in the past

1. Post Term Pregnancy Mentor: Dr.Radhika Ma’am Presented by: Aashna Raheja

2. Name: Mrs. ABC Age: 25 years Occupation: Teacher Educational status: Post Graduate Husband’s name: XYZ ; Age: 26 yrs. Occupation: Teacher Socio-economic status: Upper Middle Class LMP: 27/10/2019 EDD : 4/8/2020 Obstretic Score : G1P0L0A0 Gestational age: 40 weeks 6 days; Date of admission: 4/9/2020 Date of examination: 6/9/2020

3. Chief Complaints: The lady came for regular ante-natal checkup as her due date of delivery had passed already.

4. History Of Present Pregnancy • 1st Trimester Pregnancy was detected by urine pregnancy test following 35 days of missed period History of spontaneous conception 1st trimester scan was done and found to be normal Weight gain in 1st trimester was 800 gms Folic acid tablets were taken No h/o burning micturition No h/o fever with rashes, excessive vomiting No h/o spotting or bleeding per vagina No h/o pain abdomen No h/o exposure to radiation and drug intake Regular ANC was done

5. 2nd trimester: She felt quickening at 5th month and continued to perceive fetal movements well 2nd trimester scan was done and found to be normal. Weight gain in 2nd trimester is 3kg 2 doses dT were taken. Iron and calcium tablets taken. No h/o increased frequency of micturition and increased thirst No h/o pedal edema, blurring of vision, headache. No h/o increased appetite No h/o burning micturition No h/o of pain abdomen, leaking or bleeding per vagina

6. 3 rd Trimester history: Fetal movements are well perceived. Iron and calcium tablets taken USG was done and was normal No h/o high blood pressure No h/o of abdominal pain No h/o per vaginal bleed/leak per vagina

7. Past obstetric history: Primigravida

8. Menstrual history: LMP: 27/11/2019 Age of attainment of menarche – 11 years Regular cycle of 28 to 30 days, flow for 4-5 days Changes 4 pads per day Not associated with dysmenorrhea, No h/o of passage of clots

9. Past Medical History : Patient has no previous history of diabetes or hypertension earlier in life. Marital history: Married at the age of 21, married life of 3 years. Non consanguineous marriage

10. Family History : No history of prolonged pregnancy in mother. Personal history Diet – mixed Appetite – normal Sleep - adequate Bowel and bladder – regular No history of substance abuse No history of any known drug allergy No history of use of any contraceptives

11. Dietary History: Non vegetarian diet Breakfast:2 dosas,coconut and tomato chutney,1 cup of tea---450 cal,5 grams protein Snack:2 bananas---90 cal,2 grams proteins Lunch:3 cups of rice,2 cup pulses,1cup chicken--750 cal,25 grams protein Snack:1 cup tea,2 biscuits--120 cal,5 grams protein Dinner:3 chapathi with ghee,egg curry---500 cal,15 grams proteins Total:1950 cal,47 grams protein Required calories:2270,Calories deficient:350 cals(15.4%)

12. Summary: A 24 year old lady with an obstretic score of G1 with 42 weeks of gestationcame for a ANC visit with complaint of prolonged gestation.She can perceive fetal movements and has no other complaints.

13. On Examination: Patient is conscious, cooperative well oriented to time, place, and person and is moderately built. General Physical Examination: No Pallor ; No Icterus ; No Cyanosis ; No Clubbing ; No Lymphadenopathy No Edema Breast,Spine,Thyroid:Normal Weight:64 kgs Height-157 cm BMI:25.96kg/m 2

14. Temperature:98.9 F Blood Pressure:124/78 mm Hg Pulse:70 bpm Respiratory Rate:17 cycles per min Vitals:

15. Abdominal examination: Inspection Shape of the abdomen is globular, it is longitudinally distended Corresponding quadrants move equally with respiration Umbilicus is central and everted, flanks are filled Linea nigra present Striae gravidarum present No scars, sinuses or dilated veins can be seen Hernial orifices are intact

16. Palpation Abdominal girth is 80cm, at the level of umbilicus Fundal Height:38 weeks Obstetric Grips: Fundal Grip:Soft broad mass felt on suggestive of fetal breech. Right Lateral Grip:Uniform,continuous curved resistance suggestive of spine Left Lateral Grip:Irregular knob like structures suggestive of limb buds First pelvic grip(Pawlik’s Grip):Hard,non ballotable globular mass felt suggestive of fetal head Second pelvis grip:Fingers are diverging. Auscultation Fetal heart sounds appreciated on dopplers.

17. Systemic Examination : CNS: No focal neurological deficits CVS: S1 and S2 heard and no murmurs heard RS: Normal vesicular breath sounds heard. P/A: No hepatosplenomegaly and non tender abdomen

18. Summary: 24 year old primigravida with 36 weeks 6 days of gestation came for regular antenatal visits as her due date for delivery had passed.She can perceive fetal movements well and has no other complaints. Her vitals are normal and on obstetric examination,a live fetus is palpated with fundal height corresponding to 38 weeks of gestation and expected fetal weight of 2 kgs with hard ,non ballotable mass palpated on the first pelvic grip suggestive that the fetus is cephalic in presentation and the head is engaged.

19. Diagnosis: Extended Pregnancy as the gestation has extended 4 weeks beyond the EDD.

20. Thank You