Resultaten van een conservatief beleid bij serotiniteit

– The perinatal outcome for mother and child of a conservative management of all 176 postterm pregnancies in the Academic Hospital of the Vrije Universiteit in Amsterdam during the period 1981-1984 was examined retrospectively. A comparison was made with 176 term pregnancies of equal maternal age and parity as in the study group. In post-term pregnancies labour was induced more often. Meconium-stained amniotic fluid and foetal distress occurred in a statistically significant higher percentage in case of post-term labour, through which assistance had to be rendered more often. On an average the pH of the umbilical artery blood was significantly lower. It seems therefore desirable to maintain postterm pregnancy as a medical indication. This holds especially for primiparae, but there is an increased risk of pathology for multiparae as well. Furthermore it is concluded that the continuation of a highly individualized conservative management in case of post-term pregnancy is justified. With regard to the pH of the umbilical artery blood however it is recommendable to proceed to examination of foetal scalp blood in case the duration of the second stage of labour exceeds 30 minutes, in order to judge whether spontaneous labour can continue.