Patient's question:
I'm 12 days past my due date and still haven't had any! I want to go to the hospital for a thorough check-up, but my in-laws took me to some black clinics! They said as long as the baby's position is right, everything else doesn't matter! Today, they took me to a small clinic again, and the doctor said my amniotic fluid is low and I really need to go to the hospital! But they said the baby will grow and the amniotic fluid will naturally decrease, saying there are people who give birth after being pregnant for 11 months! They also said there's nothing wrong and that I don't need to check every day! Isn't that ridiculous! I'm so desperate now! I can't do anything about them, but I can't...! So frustrating!Doctor's answer:
In medicine, a condition where a pregnant woman does not give birth 14 days or more after the expected delivery date is called postterm pregnancy. At this stage, the mortality rate of the fetus is three times higher than normal. The placenta of a pregnant woman has a certain lifespan. About two weeks after the expected delivery date, the function of the placenta begins to decline, leading to insufficient oxygen supply and causing the fetus to frequently experience hypoxia. The placenta in postterm pregnancy is often smaller than a normal placenta when the fetus is delivered, with scattered white streaks on its surface. Sometimes, hard, stone-like calcification points can be seen, which are signs of placental aging. Due to hypoxia, the fetal heartbeat may become slow and irregular, while also causing increased gastrointestinal motility, leading to the passage of fetal feces and the pollution of amniotic fluid, which may turn green or even black, resembling mud. The amount of amniotic fluid also gradually decreases. In postterm pregnancy, the fetus often stops growing, appearing slender, wrinkled, and shriveled, resembling a small elderly person. Due to placental aging and functional decline, the fetus may suddenly die in the uterus or during the onset of labor. In some cases, the fetus may die due to asphyxia or pneumonia caused by inhaling amniotic fluid mixed with fetal feces during delivery.What should be done in cases of postterm pregnancy? For pregnant women with regular menstrual cycles of 28 days per cycle, if delivery does not occur 10 days after the expected delivery date, it is necessary to consult a doctor to check whether the placental function has declined. Based on the degree of decline, the doctor will decide whether to induce labor or perform a cesarean section. There are many methods for inducing labor. Breaking the membranes and administering intravenous oxytocin for induction is often successful. Additionally, during membrane rupture, the amount and color of the amniotic fluid can be observed, which greatly helps in assessing whether the fetus is hypoxic and the extent of the hypoxia. All induction methods are safe, causing no pain to the mother and no adverse effects on the fetus.
Of course, postterm pregnancy does not always lead to fetal or infant death. Sometimes, even though the delivery date has passed, the placental function may not decline, much like how an elderly person can still be quite healthy. However, for the sake of caution, we must not take chances. If a case of postterm pregnancy is encountered, it is best to seek medical attention as soon as possible.