Postterm pregnancy

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Patient information: Postterm pregnancy (Beyond the Basics)
Author
Errol R Norwitz, MD, PhD
Section Editor
Charles J Lockwood, MD
Deputy Editor
Vanessa A Barss, MD
Disclosures
All topics are updated as new evidence becomes available and our peer review process is
complete.
Literature review current through: Oct 2012. | This topic last updated: Feb 23, 2012.
INTRODUCTION Although pregnancy is said to last nine months, healthcare providers track
pregnancy by weeks and days. The normal duration of pregnancy is approximately 37 to 42
weeks, with the estimated due date at 40 weeks or 280 days from the first day of the last
menstrual period.
A postterm pregnancy, also called a prolonged pregnancy, is one that has extended beyond 42
weeks from the first day of the last menstrual period. As many as 10 percent of pregnancies are
postterm.
Accurate dating It is essential to ensure that the pregnancy is in fact postterm. Ideally, an
accurate gestational age is determined early in the pregnancy. In women who have regular
menstrual periods, the date can often be reliably calculated based on the last period.
If there is uncertainty about the dates, or if the size of the woman's uterus is larger or smaller
than expected based on the date of the last period, the gestational age of the fetus and due date
can be estimated based upon findings on fetal ultrasound examination. This estimate is most
accurate when performed early in pregnancy; ultrasounds performed in the last half of pregnancy
are less reliable for estimating the due date.
POSTTERM PREGNANCY CAUSES In most cases, the cause of postterm pregnancy is
unknown. There are some factors that place a woman at increased risk. The incidence is higher in
first pregnancies and in women who have had a previous postterm pregnancy. Genetic factors
may also play a role. One study showed an increased risk of postterm pregnancy in women who
were, themselves, born postterm.
However, variations in when a woman ovulates can lead to errors in calculating the true duration
of pregnancy and lead to over- and underestimations of when the baby is due. An ultrasound
examination performed in the first one-half of pregnancy is the most reliable method of
calculating the date the baby is due, especially in women with long or irregular menstrual cycles.