Management of post-term pregnancy

According to the international definition approved by the World Health Organization (WHO) and International Federation of Gynecology and Obstetrics (FIGO), post term pregnancy is pregnancy that lasts for a period of time equal or longer than 42 weeks of amenorrhea (or 294 days). It is estimated that 10% of all pregnancies continue beyond 42 weeks (the range is 3-14%) and 4% continue beyond 43 completed weeks, without any obstetrical intervention. Etiology of this clinical condition is unknown even if many specific predisposing conditions have been identified. Pathogenetic mechanism is probably related to some anomalies of factors that are involved in labor beginning. Post-term pregnancies management is extremely controversial. Many elements have to be considered: gestational age, antenatal fetal tests results, neck of uterus conditions, mother's opinion after an exhaustive explanation of risks and benefits concerning both possible managements, labor induction versus attending management. Currently many gynecologists induce labor between 41 and 42 weeks, and nearly all do not allow pregnancy to extend beyond 43 weeks of gestation.