Normal pregnancy lasts about 40 weeks from the first day of the last menstrual period. Babies born after more than 42 weeks of pregnancy are considered post-mature or post-term. The danger of post-maturity lies in the fact that the placenta, which supplies nutrients to the fetus, also ages. Small blood clots develop that interfere with delivery of nutrients to the fetus, who continues to grow. Medical personnel who care for post-term infants must prepare for, recognize and treat the potential problems of post-maturity.
Before Delivery
Step 1
Calculate the infant's due date. While a due date gives only an estimate of the delivery date, it helps determine if a baby is post-term. Knowing a baby may be post-term helps prepare for possible complications.
Step 2
Look at the amniotic fluid after membrane rupture. Post-term infants often pass meconium, the first bowel movement, before birth. If they aspirate fluid into their lungs during delivery, they can develop respiratory distress, with rapid breathing and retractions of the chest during each breath. If meconium is present, prepare suction equipment to suck fluid from the baby's nose and mouth as soon as the head emerges, to help prevent aspiration
Step 3
Observe for signs of fetal distress on the fetal monitoring strip. Placental insufficiency in post-term infants can cause fetal distress during labor, The Merck Manuals Online Medical Library reports. Post-term babies also often have decreased amniotic fluid around them, which makes umbilical cord compression during labor more likely. The baby's heart rate often drops if the cord is compressed.
After Delivery
Step 1
Recognize a post-term infant at the time of delivery. Post-term infants often have a wide-eyed, alert look. They often have peeling skin, especially at the wrists and ankles. They may have decreased subcutaneous fat and loose skin, plus long, thin arms and legs. They may also be larger than normal.
Step 2
Watch for signs of respiratory distress from meconium aspiration. Meconium aspiration syndrome causes some degree of respiratory distress in 11 percent of babies who pass meconium before birth, KidsHealth from Nemours states.
Step 3
Evaluate blood glucose levels, using a glucometer. Post-term infants often develop low blood glucose, or hypoglycemia. If levels fall below 36 mg/dl, the infant should immediately be breastfed or given formula to raise his levels, Stanford University Medical Center states. Severe hypoglycemia can cause seizures, tremors, loss of consciousness or brain damage.
Step 4
Check the arms and shoulders for limited movement that could indicate nerve damage, if the infant is larger than normal. Injuries to the collarbone and nerves in the arm can occur during the delivery of larger than normal infant.
Tips and Warnings
- Meconium passage before labor can stain a baby's skin or nails yellow or green.
- Babies with meconium aspiration syndrome may later develop reactive airway disease such as asthma.
