Dr. Noah O. Olaomo
A pregnancy that is more than 40weeks is said to be *postdated.* A pregnancy that is more than 42weeks is *prolonged.* No pregnancy should be allowed to exceed 42weeks except the woman refuses intervention. A postdated pregnancy should be closely monitored.
There are increased chance of the baby getting bigger than expected and the liquor (amniotic fluid) reducing to subnormal level with postdated and prolonged pregnancies. *A postdated pregnancy should be induced between 41 and 42 weeks for a good pregnancy outcome.*
Induction of labour is artificial initiation of labour when it is in the best interest of the mother and child. You may be advised to monitor your fetal kicks at this stage.
DANGER SIGNS (REDFLAG SIGNS) IN PREGNANCY.
Below are some redflag signs that every pregnant woman should pay attention to-
*Bleeding:* Any bleeding from your private part at any stage of your pregnancy irrespective of the amount should make you consult your doctor urgently. Bleeding before 28weeks might be due to a miscarriage or some other problem and requires you consulting your doctor urgently to avoid complications.
*Bleeding after 28 weeks is referred to as antepartum haemorrhage* and is most commonly due to *placenta praevia* (low lying placenta) and *placenta abruption* (premature separation of placenta before the baby is born). Both conditions are dangerous to both the mother and the baby and should urgently been attended to by the medical team.
*Drainage of liquor (water):*
Drainage of liquor (water) through the private part at any time in pregnancy before the onset of labour should be promptly attended to. It may lead to miscarriage, preterm delivery, serious infections and a lot of other untoward events. Therefore, drainage of liquor by a pregnant woman who is not in labour should prompt immediate visit to your healthcare provider.
*Fever:* Fever in pregnancy should be promptly investigated and treated as this can trigger preterm labour and compromise fetomaternal (baby and mother) wellbeing.
*Elevated blood pressure:* Any blood pressure above 140/90mmHg at any time in pregnancy should be properly assessed by your healthcare team and appropriate measures instituted. Do not trivialize an elevated blood pressure in pregnancy.
*Headache and blurring of vision:* The occurrence of headache especially in the forehead with blurring of vision with elevated blood pressure should be urgently managed in a competent health facility. It is usually a warning sign of eclampsia.
*Eclampsia:* is when a pregnant woman with elevated blood pressure, protein in urine with or without some other medical findings begins to convulse. It is a serious emergency that should be prevented at all cost.
*Cramp like lower abdominal pain:* The occurrence of frequent cramplike (like menstrual pain) lower abdominal pain before 28 weeks might indicate a miscarriage especially if accompanied by bleeding from the private part. Also, cramplike lower abdominal pain after 28weeks but before 37weeks may be preterm contraction/labour. You should visit the hospital promptly if this occurs.
Labour starts when painful contractions begin every 10-15 minutes. As it progresses the contractions become more frequent and more painful. It ends when the baby and the placenta have been successfully delivered.
A labour may result in you delivering yourself or in Caesarean section if it is necessary.
Caesarean section might be needed because of the mother, baby or both of them. It is a lifesaving intervention when properly used and should not be seen as evil.
It is wise to allow your labour to be properly supervised by trained doctors and midwives. A normal established labour should last 8-12hours.
*POSTDELIVERY CARE (POSTPARTUM CARE)*
This is the care given to you from delivery to 6weeks after. At 6weeks, your body is expected to have returned to its pre-pregnant state. You will be given a follow up plan that suits your situation, usually 2weeks and 6weeks for CS and 6weeks for normal delivery. Your wellbeing will be checked at each visit, these include-
A. You should still check your BP and urinalysis frequently at this time. Some women have eclampsia at this stage.
B. Continue your routine drugs to replenish what you have lost.
C. Pay attention to the health of your baby(ies).
D. Breastfeed exclusively except otherwise stated medically.
E. Ensure appropriate immunization for your newborn(s).
F. Go for family planning counselling sessions and choose the method appropriate for you and your spouse.
Thank you for your time since we began this series on Taking Care of Pregnancy. We have more insightful topics for your reading pleasure.
Dr Olaomo Noah Oluwafemi is a Consultant Obstetrician and Gynecologist with a love for writing. His desire is to enhance people’s lifestyle and effect positive change in their health through his writings