Post-term induction of labor revisited

Post-term pregnancy (longer than 42 weeks or 294 days) occurs in approximat ely 10% of all singleton gestations. The adverse outcomes of post-term preg nancy include a substantial increase in perinatal mortality and morbidity. ACOG currently recommends induction of labor for low-risk pregnancy during the 43rd week of gestation. However, that recommendation dates from 1989. R ecent reports mandate reconsideration of the management of post-term pregna ncy, including reinterpretation of the statistical risk of stillbirth in po st-term pregnancies using ongoing (undelivered) rather than delivered pregn ancies as the denominator, which shows a far higher risk to post-term fetus es than believed. Recent data also suggest that the risk of cesarean delive ry after induction of labor at term is lower than reported, possibly becaus e of improvements in methods for cervical ripening. Those findings provide rationale for earlier labor induction in low-risk pregnancies. (Obstet Gyne col 2000;96: 779-83. (C) 2000 by The American College of Obstetricians and Gynecologists.).