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Normal duration of pregnancy in humans. The size of the abdomen and uterus: labor soon? Methods for determining the date of birth

It is not clear why people say that pregnancy lasts 9 months, but in fact it is 40 weeks. If it lasts a little less, it should be considered premature. Of course, it is impossible to determine with certainty the exact date of birth. Of course, you can calculate the preliminary date of birth quite accurately, but it is not a fact that it will be true. Almost no one, not even doctors, will be able to say with certainty how many days your organism's pregnancy lasts, and how many days there will be childbirth. There is no single answer to the question of how many weeks pregnant women go, since this period depends on a huge number of factors. Even if you know exactly when conception occurred, you will not be able to know how fast the sperm turned out to be, how long it took to implant into the egg, how long it took to move through the fallopian tubes, how long the fetus will develop in the womb. It all depends on the individual characteristics of the organism. However, there is still a small pattern of how long pregnancy lasts most often, and when the baby is ready to be born. One can only rely on these calculations, but not one hundred percent hope. Certain calculations have shown that pregnancy ends at 37-42 weeks. In the event that it is 43 weeks, labor is called artificially so that there are no problems with the placenta and the baby's breathing.

So how long is pregnancy according to the midwife count? In most cases, women have 38 weeks from the moment of fertilization to the onset of labor, which is 266 days per day. However, most often women do not know the exact moment of fertilization. But, most likely, they perfectly remember the date of the last menstruation. It is she who is taken for the basis of the calculation. Gynecologists say that on average, 280 days pass from the first day of menstruation to childbirth. Most likely, the actual gestational age is two weeks less than the so-called menstrual period.

If you count the number of days, you can see that the period is exactly nine months, as people are used to saying. The average cycle lasts about 28 days and is the standard for most women. That is why a period of 40 weeks is calculated mainly for a cycle of 28 days.

How long the pregnancy lasts will be influenced by many other factors: first of all, the state of health of the expectant mother will have an important influence. Depending on what lifestyle the woman led, the speed of his condition, psychological background will depend. It also happened when a woman gave birth on a day set for herself, for example, for a holiday, or for the return of her husband from a long business trip. However, the psychological attitude is not always decisive. A factor such as heredity has a huge impact on how long a pregnancy lasts. If your mom gave birth to you before the due date, chances are good that you will have the same. Almost all calculations are arbitrary, and it is impossible to try to conceive a child in order to give birth on New Year's Eve. If at the end of the term you have some doubts about whether you have carried the child, you should pay attention to your well-being and to the behavior of the baby.

In any case, doctors monitor pregnancy closely and all recommendations should be followed. It's hard to disagree that no matter how long or hard this period is truly magical! You don't need to worry about trifles, you just have to enjoy your state, because it will end pretty soon. It remains to wish only easy childbirth and health to the baby!

It is generally accepted that the number of days from conception to childbirth is 280, but this is only a conditional number of days of bearing a child, which is calculated from the first day of the last menstruation. In fact, the average duration of pregnancy to delivery from the day of conception is 267 days. A full-term baby is considered to be born between 253 and 281 days of pregnancy. Therefore, a child born a week and a half ahead of schedule, in this case, the expected date of birth (PDD) cannot be considered premature, and children who delayed the birth for the same period are not delayed.

Each pregnancy is individual, and children themselves decide when to be born in view of their maturity - as nature has provided. After all, a woman can never say with confidence the exact day of conception, since the survival rate of sperm is ten days, this suggests that fertilization can occur a week after unprotected intercourse.

Methods for counting days to childbirth from the day of conception

The average pregnancy lasts 38 weeks, but this does not mean that at exactly 38 weeks, childbirth in the interval of 37-41 weeks of pregnancy is considered normal.

There are different methods for determining the duration of pregnancy and the expected date of birth:

  • From the first day of the last menstrual period
  • By ultrasound
  • (the most inaccurate and absurd, since every woman can feel the movement of the baby at different times, it depends on many factors, one of them is the severity of the fat layer on the abdominal wall)

To find out how many days before childbirth from conception, it is difficult to determine the exact date of conception or ovulation, so gynecologists calculate the date of birth from the last menstruation, since almost all women remember this date. It's a paradox, because a real pregnancy cannot occur in, therefore, the gestational age calculated in this way is usually called menstrual or gestational, in fact, conception occurred about two weeks later, that is, at the time of ovulation, this period is called ovulation or fertility.

As a rule, ovulation occurs fourteen days after the end of menstruation, so if you count how many days from conception to childbirth, you need to subtract fourteen days from the average duration of pregnancy, that is, 280 minus 14, you get 266 days. But again, everything is individual and in some cases ovulation may occur a little earlier or later. Therefore, gynecologists came to the conclusion that pregnancy is considered a normal duration of 266-294 days, that is, the conditional number of days of pregnancy plus or minus fourteen days.

Confusion with the timing of pregnancy occurs in every third girl, and misunderstandings between the doctor and the expectant mother are even more frequent. After all, it is always interesting when a baby will appear and whether it is possible to plan his birth. How many weeks a woman's pregnancy lasts is not fully understood. But there are generally accepted criteria for nine months. How to determine the term, and what affects the duration of pregnancy?

For accuracy, gynecologists determine the duration of pregnancy in weeks and days. This is especially important for premature babies. Each day of intrauterine "residence" is equal to a week in the intensive care unit. In everyday life, it is generally accepted to deduct by months, and especially responsible women tend to count from the date of the alleged fertilization. How is it correct?

How long can pregnancy last?

Even such a seemingly elementary question is surrounded by many disputes and contradictions. It is generally accepted that women carry a baby for nine months. However, it is more correct to speak about the lunar, when there are 28 days in one month. But numerous observations of women show that there is no strict parameter that determines the date of birth. In this case, the gap is about a month.

Recent studies in this area indicate that exactly 38 weeks pass from the moment of conception to the birth of a baby, and another two days - 268 days. But, given that not everyone knows ovulation and the days of fertilization, there is an average framework for determining the duration of pregnancy and the expected date of birth. So, women are in the position for the following amount of time:

  • nine months - lunar;
  • 40 weeks - variations from 37 to 42 are allowed;
  • 280 days - respectively from 259 days to 294.

Sometimes women give birth even after 42 weeks, but this is considered a post-term pregnancy and is accompanied by a high risk of complications for the baby.

Non-developing

Stopping the development of the embryo / fetus can occur at different times, right up to the very moment of childbirth. The first signs of a non-developing pregnancy may appear only a month after the baby froze. If this occurs before the 2nd trimester, spotting appears. In the case when an already large baby stops developing after 16-22 weeks, first of all, the woman notices that the child has stopped moving.

Considering the fact that a frozen pregnancy from the moment of fetal death proceeds with little symptoms for a long time, it is often a find when performing a planned ultrasound scan at 12 or 20-22 weeks.

Ectopic

There is no sense in determining how long an ectopic pregnancy lasts. All the same, its further development will be impossible. The approximate period can be set based on the first day of the last menstruation, as well as on the level of hCG.

On average, an ectopic pregnancy begins to manifest itself (pain in the lower abdomen, spotting) in the fourth to sixth week. It is extremely rare that it is asymptomatic for up to eight weeks. The thing is that it stretches the fallopian tube (in 90% of cases it is formed here) and leads to its rupture. And since the fallopian tube has a very small diameter and its ability to stretch is limited, the rupture occurs somewhere in the fourth or sixth week.

Multiple

The duration for multiple pregnancies is the same as for normal pregnancies. But it is more difficult for the body to bear two or more children, so often contractions or water leakage begins before 40 weeks. Also, sometimes delivery occurs according to indications from the mother or fetus ahead of schedule.

After IVF

The duration of gestation during pregnancy after IVF is also individual and does not depend on the fact that assisted reproductive technologies were used. To calculate the period, the date of the last menstruation is used, and for clarification, the date of embryo replanting is used.

False

In medicine, there is such a thing as "false pregnancy". Most often, the condition occurs in women with mental disabilities. They are sure that they are carrying a baby, they are starting to gain weight, including in the abdomen. However, this is nothing more than a psychological conviction. A false pregnancy can last as long as you like, but it has no result.

The generally accepted term for full-term pregnancy is 37-42 weeks. All labor that begins earlier is considered premature. If necessary, labor can be induced at any time, or delivery can be carried out by caesarean section. Such a situation is possible with an intrauterine deterioration in the condition of the fetus, with the depletion of a woman's reserve forces, for example, with gestosis.

How to define an "important day"

From the moment of pregnancy, it is important to know its duration. It can be used to judge the following:

  • how pregnancy develops- exclude frozen, ectopic;
  • when to perform ultrasound- screenings are performed to identify fetal abnormalities;
  • approximate due date- this is especially important if there are any abnormalities in the development of the fetus and it is necessary to deliver the woman ahead of time, and also in order to exclude overmaturity.

There are different ways to determine the prenatal age of the baby and the estimated time of his birth. Today there are a large number of mobile applications that help you figure this out. If a woman's menstruation is regular, they are the main reference point.

By monthly

The countdown starts from the first day of the onset of menstruation. In a week - a period of one week, in a month - four, and so on. It turns out that with a delay, it is on average five to six weeks. This is an obstetric, average term that does not take into account the day of conception.

To determine the due date, it is necessary to "decompose" the date of the last menstrual period. Namely, take the month and subtract the number three, and then add seven to the first day (date) of menstruation, and add up the months and days. For example, if the period was 11/09/17 - 11/13/17, then the baby's date of birth will be as follows:

  • determine the month- 11 (were in November) - 3 = 8 (childbirth in August);
  • we define the day - 09 (first day) + 7 = 16.

Thus, 40 weeks will be August 16, 2018.
You can simply count from the first day of your last period by week using the calendar.

By ultrasound

When performing a study by the size of the fetus or ovum, you can also judge the duration of pregnancy. For many years of using this method in pregnant women, average values ​​and special tables have been compiled, taking into account obstetric calculus. This takes into account:

  • in the early stages- the size of the fetal vesicle;
  • at 12 weeks - body length from head to toes;
  • at a later date - the length of the upper and lower extremities separately, the size of the head, abdomen, and brain structures.

The most accurate way is to determine the gestational age by ultrasound at 12 weeks, as well as at any time by the size of the cerebellum. By setting the number of days of pregnancy, the program automatically calculates the expected due date, that is, when it will be 40 weeks (280 days).

At the first appearance in the residential complex

During the first appointment in the consultation, the doctor must conduct a vaginal examination to determine the size of the uterus. If the term is long, it is supplemented with a visual assessment. From these data, a specialist, without any other data, can establish the gestational age and then calculate the approximate date of delivery.

By wiggle

The gestational age can be determined in other ways, but they are less accurate and are used only as ancillary. In particular, you can take advantage of fetal movements. The postulates by which the calculation is carried out are as follows:

  • in primiparous - the first movements begin at 20-22 weeks;
  • in multiparous - at 18-20 weeks.

By comparing all the data, the doctor determines the main due date and date of delivery. Most often, they are repelled from menstruation, and in case of their irregularity, from ultrasound at 12 weeks and the size of the fetal cerebellum at any time.

Why the dates don't match

Many women become blurred with doubts about when to give birth, since the timing, calculated in different ways, does not coincide. Indeed, this is possible. After all, any date is approximate, but how long a normal pregnancy in women lasts is not fully understood.

Recent studies in this area indicate that the timing depends on the time of implantation of the ovum and the level of sex hormones. The relationship between the level of progesterone and how long the pregnancy lasts on average was found. It turned out that the higher the level, the shorter the gestation period.

Most often, the timing mismatch is detected by ultrasound and menstruation. Especially in the 2nd and 3rd trimesters. Moreover, in the 1st trimester, they may be the same. This is observed in women who are pregnant with twins, carrying a large or small fetus. This is due to the fact that ultrasound is guided by size. For example, the greater the weight of the child, the closer the birth date will be calculated, although the actual (for example, monthly) will be much later.

Therefore, one should focus only on the data obtained at 12 weeks.

Misconceptions about carrying

There are no exact dependencies about how long a woman's pregnancy lasts in a given situation. The most common misconceptions are the following:

  • multiparous do not wear up to 40 weeks- This is explained by the fact that the body still "remembers" the previous birth, and therefore everything happens faster;
  • girls are born faster, boys are always overdue- this is usually argued by the fact that boys are in no hurry, and girls are faster and develop faster;
  • if everyone in the family has been postponing, it will always be so- in fact, how many obstetric weeks the pregnancy will last depends on the woman and the fetus, and only a little is determined by hereditary predisposition.

Reviews of women prove that this is nothing more than superstitions and folk omens, which are confirmed only in one out of ten cases, which may be a simple coincidence.

What can really affect

Some regularity between how many months the pregnancy lasts and other circumstances has been found. The following women carry longer:

  • older age- a year of age from a previous pregnancy adds a day;
  • with a higher increase for pregnancy- 100 g also in one day in comparison groups;
  • if the previous pregnancy was more than 38 weeks- the next time the probability of long gestation is higher.

The question of how long pregnancy lasts in women and what factors determine this is still open. There are only approximate terms - 37-42 weeks, counting from the first day of the last menstruation. The body of every woman finds its own landmarks. But it is from 37 weeks that all systems and organs of the baby are considered mature, therefore, if necessary, it is possible to induce labor according to indications.

Reviews: "Children themselves" know "when to come to this world"

I have all the later PDR, both boys and girls.
1 - girl - 40 weeks 4 days
2 - boy - 42 weeks exactly
3 - girl - 41 weeks 13 days
4 - boy - 40 weeks 5 days.
All by ourselves, without stimulation.

Taisa, http://forum.forumok.ru/lofiversion/index.php?t4172-150.html

Even with an ultrasound scan, there are errors in determining the duration of PDD. I gave birth to my little son on March 31 (as I expected myself), in the maternity hospital they said that the baby was full-term, and the doctors set the PDD on March 16. Mom herself carried me for three weeks ... So the kids themselves "know" when to come to this world :-))

Olga Sochneva, https://deti.mail.ru/id1003122446/

Not true. Here, everyone is different. Here the girl wrote about the quadruple ... With me lay a girl, the sixth gave birth, all at 38 weeks, the sixth - at the 41st week. I gave birth to both of them day after day, my daughter was later in time.

Olga, https://www.babyblog.ru/user/lenta/23F77

I also thought so, and I have been preparing since 36 weeks! And she gave birth day after day, as the doctor delivered not earlier and not later, they told me that the second childbirth, and even the girl did not go, only she decided differently here.

Zarina, https://www.babyblog.ru/user/lenta/zarishka

My daughter is at 36-37 weeks and my son is also always at odds with the doctors, I think, I get 38 weeks, and they have 2 weeks less and I also noticed that the very first time they put PDR at 12 weeks or even earlier and will be the most accurate
they put me and my daughters like that at 12 weeks-pdr on August 6
on week 28 - August 16
at 34 weeks - already on August 26
and she was born ... on August 3
and it's the same with my son
the first time we were at 6 weeks, because as a threat, and put on January 10
then 15, and at the end 28
so what do you think?
son was born on January 3

Vishenka, http://www.stranamam.ru/post/3838182/

Print

Every woman who has given birth, at least once, remembers pregnancy and childbirth throughout her life. And how interested she was to know when the pregnancy began, how long a person's pregnancy lasts, days and weeks, and, of course, the time of the onset of labor. And you, as a mother-to-be, are also interested in learning about the timing of pregnancy. We will try to talk about this in our article.

There are certain methods of counting. Let's consider the most commonly used ones.

Obstetric method. With the obstetric counting method, which is considered the most universal and used by all gynecologists, at the initial visit by the doctor, the woman is examined with her hands, the size of the uterus is ascertained, and the gestational age is determined based on the measurements obtained.

According to the definition of gynecologists, the beginning of pregnancy is the first day of the last menstruation, from which the uterine mucosa is prepared for pregnancy and the egg begins to mature.

In obstetrics, the duration of pregnancy is calculated as 280 days, that is, 40 weeks or 10 lunar months. It fits into 9 months if you use calendar months.

When using this method, the estimated due date (PDD) and the period of maternity leave are determined.

In the language of official medicine, PDD is the day, month and year of your baby's birth. It should be remembered that the DA is an indicative date. If we turn to statistics, then only 4 out of 100 children appear exactly at a certain time.

In addition to the doctor, the woman herself can easily calculate the PDD. To do this, subtract 3 months from the first day of your period and add 7 days. For example, the beginning of the last menstruation is July 10, we subtract three months - we get April 10. We add 7 days - we get April 17. This is the likely due date.

To obtain the PDR, you can refer to the table compiled by the date of the last menstruation. To do this, we will find in it the first day of the last menstruation, for example, January 11 (gray line), then in the white line we will see October 18 - the estimated date of birth.

Read also:

PDR definition table:

The calculation of the duration of pregnancy can be done by other methods.

Pregnancy period from conception. So in the embryonic (true) period - from conception, the beginning of pregnancy is the first day of the last menstruation plus 2 weeks.

The basis for such a calculation of the period is the possibility of the onset of ovulation (the release of an egg by the ovary) between 8 and 16 days of the menstrual cycle, and, accordingly, the period when the fertilization of an egg is possible can vary from 8 to 18 days.

Therefore, the duration of pregnancy using this method is estimated at 266 days or 38 weeks.

The considered values ​​of the timing are typical for a normal pregnancy.

Norm or pathology

The norm of pregnancy physiological adaptive changes in the body of a healthy woman during pregnancy without any complications are called.

Duration normal full-term (full) pregnancy from fertilization to childbirth is 38 to 42 weeks.

The duration of pregnancy may be different.

Premature birth

In some cases, the onset of childbirth occurs earlier than it is determined by nature. A perfectly healthy mother should not have a premature birth (between 22 and 37 weeks). This usually happens for some reason.

So the reasons for the onset of premature birth can be:

  • SARS transferred during pregnancy; kidney disease, diabetes, hypertension, heart defects and others;
  • abortion and miscarriage;
  • sexually transmitted infections;
  • work associated with heavy physical exertion;
  • emotional stress;
  • alcohol, drug and smoking;
  • drug abuse.

Postterm pregnancy

The so-called term of birth is a very conditional concept. No doctor can say with certainty: "You will give birth on April 12th." He may answer that labor is most likely to begin between April 6 and 16. However, there are often times when April 16 is behind, and the woman is still awaiting birth. Since the rate of maturation for each child is different, then fully mature children can be born on the 302nd day. This pregnancy is called prolonged (prolonged).

But often there are cases when the baby is already ready for childbirth, and the uterus is not yet ready.

Such a pregnancy is called post-term and medical intervention is required.

In any case, if the pregnancy lasts more than 42 weeks, doctors assume a post-term pregnancy, the woman is asked to go for an examination and drugs are prescribed to promote the development of labor.

Postterm pregnancy occurs in women due to:

  • with irregular periods;
  • diseases of the liver, stomach and intestinal tract;
  • low mobility during pregnancy;
  • with strong psychological stress (for example, studying at the institute).

Both conditions and premature birth and post-term pregnancy can lead to an unfavorable outcome during childbirth, therefore, the medical staff should monitor the condition of the mother and the unborn baby.

Trimesters of pregnancy

In obstetrics, there is a concept “ trimesters of pregnancy”Are periods of three months.

First trimester(from conception to 13 weeks) is the most difficult. At this stage, the body of the mother and the embryo gets used to each other and most of the difficulties and problems arise, for example, nausea, fatigue.

Second trimester(from 14 to 27 weeks) - the time of active growth and maturation of all systems of the unborn child. The mother senses this through weight gain and an increase in the abdomen. The state of health improves significantly. In the middle of the trimester, the first movements of the baby appear.

Third trimester(from 28 weeks to childbirth) - home stretch. This trimester is often the most difficult physically. The woman had a significant increase in the size of her abdomen, there was a feeling of awkwardness: difficulty with walking, the ability to sleep and sit. But still this is the most joyful period. You have already passed most of the way. Ahead is the birth of a new life.

You are now prepared. And you can safely move forward to a wonderful event - the birth of your baby.

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When the expected date of delivery of a woman comes, and there were no signs of the readiness of the female body for childbirth, and there are no signs, many wonder what the maximum gestational age is possible.

Also very important is the question of how to determine the true overdue, what consequences of late birth can be for the mother and the fetus. And here statements such as: "There is no chronic pregnancy, if you give birth, where are you going to go" are absolutely unacceptable.

Overburdening is called a pathological phenomenon in which labor appears belatedly or does not appear at all at the end of the pregnancy. When delayed labor occurs, its various anomalies (for example, weakness and discoordination) and violations of the contractile readiness of the uterus are often stated.

This phenomenon is a rather serious problem in obstetrics and occurs in 4% of cases. Due to the high likelihood of violations of the process of childbirth with delayed labor, the number of surgical interventions is increasing. The risk of complications in parturient women during and after childbirth increases. The risk of impaired intrauterine development of the child and even his death increases.

What is the maximum gestational age in days and weeks?

The gestational age, and with it the date of birth, is calculated in several ways. It can be counted by the first day of the last menstruation, by the date of conception, by the size of the uterus at the first visit to the doctor and at the first ultrasound, by the date of the first movement of the crumbs.

The most reliable way of calculating the date of birth is by counting the first day of the last "critical days". From their first day, three months ago are counted and 7 days are added. This will be the estimated date of birth of the baby with a normal duration of bearing a child of 280 days.

Despite the fact that during the menstruation itself, there can be no question of any fertilization, the calculations are carried out in such a way that the pregnancy lasts 280 days and plus or minus two weeks. Thus, it turns out that pregnancy lasts 40 weeks, and childbirth at 38 weeks cannot be called premature, as well as childbirth at 42 weeks - late.

In obstetrics, there are two concepts of overweight - true and imaginary overweight.

The first option is confirmed when the pregnancy continues for more than 14 days after the calculated date of birth of the baby (that is, the duration of pregnancy is 294 days or more) and when the baby is born with signs of overmaturity.

In this case, the development of pathological disorders in the structure of the placenta necessarily takes place (fatty degeneration, multiple petrification - deposits of calcium salts in the placenta).

The final conclusion can be given after examining the newborn and examining the placenta.

Another option is imaginary overburdening. It is also called prolonged pregnancy. In this case, pregnancy is characterized by an extended period of its course for the physiological maturation of the child. Such a pregnancy ends at 294 days or later with the birth of a mature baby without any complications.

In the process of examining a pregnant woman with suspicion of prolongation, it is important to exclude chronological prolongation (incorrectly calculated period of pregnancy and childbirth).

Causes

Here, rather, we have to talk about risk factors for the development of delayed labor.

Consider these risks from the mother's body and from the baby's side.

Maternal risk factors:

  • violations in the state of the reproductive health of a pregnant woman. Such disorders can be inflammatory diseases of the reproductive system, leading to endocrine disorders and changes in the neuromuscular system of the uterus, history of abortion, infantilism of the maternal body, irregularity of the menstrual cycle;
  • the age of a woman preparing for motherhood for the first time is over 35;
  • maternal pathologies accompanying pregnancy. These can be metabolic diseases, endocrine pathology, pathology of internal organs, gestosis and toxicosis, mental shock;
  • a sedentary lifestyle during pregnancy, especially in its final stages;
  • hereditary predisposition. Often there is a regularity of repeated cases of prolonged pregnancy in a family where the closest relatives have already had late childbirth.

Possible fetal causes:

  • often the reasons that caused the delayed development of the fetus lead to an extension of the gestational age. In this case, such a phenomenon as the prolongation of pregnancy can be considered an adaptive mechanism that contributes to the maturation of the fetus;
  • a large fruit weighing over 4000 g. A large baby often cannot descend to the entrance to the small pelvis. This interferes with the proper opening and preparation of the uterine pharynx for childbirth;
  • for the same reason - the inability to descend into the small pelvis - the transverse or breech presentation of the child also contributes to an increase in the gestational age;
  • an immature baby's immune system due to a lack of nutrients.

Tests that can confirm that the gestational age has been exceeded

Diagnosis of post-term pregnancy is difficult, since the clinical manifestations of this pathology are erased.

First, the gestational age is recalculated again and the estimated date of birth of the baby is checked. The risk factors for overburdening are determined. A more thorough obstetric examination is then performed.

Methods for determining dates and dates have already been discussed above. Let's go straight to the obstetric examination.

Examination data supporting post-term pregnancy:

  • weight loss of the expectant mother by 800-1000 g per week (sometimes more) after 41 weeks, together with the appearance of signs of a decrease in skin elasticity;
  • a decrease in the size of the abdominal circumference by 5-10 cm after the 290th day of pregnancy;
  • the height of the standing of the fundus of the uterus stops growing or decreases;
  • the mobility of the fetus decreases due to lack of water. The woman feels movements less often. Moreover, these movements are not intense, but sluggish, "lazy";

Vaginal examination allows you to determine that:

  • the cervix is ​​not prepared for childbirth (the cervix is ​​long, not elastic, the cervical canal is tightly closed);
  • the bones of the baby's head are dense, the bone sutures and fontanelles cannot be felt.

Obstetricians-gynecologists regularly listen to the baby's heart sounds with an obstetric stethoscope. When overdue, the nature of the heart tones of the crumbs changes - their sonority, heart rate, rhythm change. However, these changes are not specific to overmaturity, but to a greater extent indicate the oxygen starvation of the baby.

The gynecologist observing the pregnancy, after carrying out the above examination at forty weeks of gestation, recommends hospitalization in the maternity hospital. The purpose of hospitalization is to clarify the obstetric status of the expectant mother and the condition of the baby. A specialized hospital has more opportunities for detailed, in-depth examination of expectant mothers, so you should not be afraid and avoid hospitalization.

Instrumental examination methods a pregnant woman in a hospital are used to determine the functional state of the fetoplacental system, to determine further tactics for managing a pregnant woman and to choose a method of delivery in this particular case.

Fetal cardiotocography

Fetal cardiotocography (CTG) reveals changes in the state of the fetal cardiovascular system. Mainly, this method allows you to determine the presence of oxygen starvation of the baby (hypoxia). Indicators such as the lack of reactivity of the baby's cardiovascular system to his movements (non-stress test) or uterine contractions (stress test), although they are not specific for prolonged pregnancy, but they indicate that the fetus is not doing well.

They are manifested by the monotony of the heart rate, an increase in heart rate of more than 150 beats per minute or a decrease in their frequency of less than 110 beats per minute. If such changes are detected, expectant tactics are not used; urgent action must be taken to save the child.

Amnioscopy

Amnioscopy is a procedure for examining the lower pole of the ovum, which is performed only in a hospital setting. This examination will help with prolongation:

  • determine low water (a decrease in the volume of amniotic fluid);
  • find impurities of meconium (original feces) in the amniotic fluid. When prolonged, the amniotic fluid turns green with meconium impurities. Green amniotic fluid is one of the main signs of baby's hypoxia;
  • determine the absence of a suspension of vernix flakes in the amniotic fluid.

Ultrasonography.

Ultrasound allows you to determine the volume of amniotic fluid, including over time. It has been scientifically proven that the maximum amount of amniotic fluid is observed at 38 weeks. Subsequently, their volume decreases rapidly. In the literature, average figures are given for a decrease in the volume of amniotic fluid by 145-150 ml per week. As a result, by the 43rd week, the reduction is 244 ml.

A decrease in the volume of amniotic fluid is considered as a natural process of dysfunction of the placenta due to its aging during prolongation.

Also, when prolonged, ultrasound reveals the so-called echo-positive changes in amniotic waters due to the content of meconium and fetal epithelium in them. Echo-positive signs indicate that the waters are no longer clear.

In this case, ultrasound can show a decrease in the thickness of the placenta, reveal its structural changes (heterogeneity, cysts, degeneration, petrification).

In favor of exceeding the terms, ultrasound data say that the size of the baby is large, but there is no increase in dynamics, the bones of the skull thicken, their density increases.

Doppler ultrasound

Ultrasound with dopplerometry allows you to investigate the state of blood flow in the uterine arteries, which makes it possible to draw a conclusion about the state of blood circulation in the uteroplacental basin.

For dopplerometry, the umbilical arteries are more accessible, and the assessment of the state of blood flow in them is most indicative. The state of the peripheral bed - the vasculature of the fetal part of the placenta - is also assessed.

With prolonged pregnancy, the blood flow in the microvessels of the villi is disturbed and their vascularization (blood supply) decreases, which leads to a deterioration in the blood supply to the child. As a result, there is a lack of oxygen supply, that is, oxygen starvation (hypoxia) of the fetus.

Biochemical studies of hormone levels

Biochemical studies of hormone levels during prolonged pregnancy show a decrease in estrogen levels. By the indicators of the fraction of estriol in the blood and the level of its excretion in the urine, one can judge the functional state of the mother-placenta-fetus system. Only the doctor will analyze these results, and the mother's task is to listen carefully and follow his instructions.

To confirm post-term pregnancy, it is necessary to monitor laboratory parameters and data from instrumental research methods at intervals of 24-48 hours.

Signs of a postmaturity of a newborn

  • dry flaky skin;
  • there is no original lubricant;
  • maceration of the skin - increased striation of the skin of the palms and piles of the baby ("bath" feet and hands);
  • dense bones of the skull, narrow sutures, small size, large fontanelle. The cranial bones lose the ability to change their location in the process of passing through the birth canal (weakly expressed configuration);
  • poorly expressed subcutaneous fat;
  • large size of the fetus (less often malnutrition - a decrease in body weight due to an eating disorder);
  • multiple folds on the skin due to a decrease in its elasticity ("senile" appearance of the child);
  • long nails on the toes of the baby;
  • meconium staining of the skin of the crumbs, umbilical cord, fetal membranes (dirty green or gray).

A combination of three or more of the above signs in a newborn baby confirms the overripe condition of the fetus.

Consequences for mother and child

Almost all the consequences of prolongation are associated with impaired function of the placenta due to its aging. Thus, the fetus does not receive enough nutrients and oxygen. Considering that in the later stages the needs of the body, and especially the baby's brain for intensive nutrition and blood supply, increase, this discrepancy between what is needed and what is received can have serious consequences.

The development of the fetus is slowed down. After birth, such children often experience disturbances in the functioning of the respiratory and cardiovascular systems. Babies sitting in the womb often get meconium amniotic fluid into the lungs. This leads to inflammatory processes in the lung tissue, which manifests itself immediately after birth with respiratory disorders.

Overripe children are usually large, their skull bones are dense and poorly configured (change their position when passing through the birth canal). Therefore, during post-term pregnancy, the risk of maternal and infant injury during childbirth is very high. In babies, when moving along the birth canal, cephalohematomas may form and even hemorrhage in the brain may occur, there is a high probability of collarbone fracture or joint dislocations.

For a mother, the birth of such children in a natural way can threaten with a rupture of the birth canal (vagina, neck, perineum) and extensive blood loss. Also, due to the poor contractile activity of the uterus, such women often experience uterine bleeding after childbirth, especially in the early postpartum period.

Based on all of the above, we can say with confidence that when a woman is confirmed that she is overweight, it is normal to give birth to her in a natural way - there is little chance. Therefore, the usual tactic of most doctors in such cases is the delivery of such women by caesarean section.

Of course, the question of the method of delivery is decided individually, taking into account many factors, such as:

  • maturity of the uterine pharynx,
  • readiness of the birth canal,
  • the size of a woman's pelvis,
  • fetal position,
  • linear dimensions and weight of the child,
  • data on oxygen starvation of the baby,
  • the effectiveness of the preparation of the cervix,
  • concomitant pathology of the expectant mother, and so on.

Summing up, I will say that the most important thing for a woman in late pregnancy is not to let things go by themselves, but to continue to be observed and examined. After all, I do not want the most cherished and joyful event in the life of every woman to be overshadowed by the health problems of mom or baby.