Late pregnancy: risks and whether they can be avoided. Positive aspects of late motherhood

Fetal development at 42 weeks of gestation

All organs and systems were ripe for a new life stage several weeks ago. A little more - and you will see your baby! Perhaps now his skull bone density has increased and the process of overgrowth of the fontanel (bone calcification) has begun. In addition, at 42 weeks there is a decrease in the amount of vernix lubrication, which protects the fetal skin from exposure to amniotic fluid and facilitates passage through the birth canal. All this indicates that the baby should hurry up!

Medical observation

If the doctor has suspicions about the presence of risk factors, an ultrasound, amnioscopy and Doppler ultrasound are performed at the 42nd week of pregnancy. These procedures will allow you to evaluate several parameters:

• The degree of aging of the placenta;
• The amount of amniotic fluid;
• Type of amniotic fluid (determining color and transparency gives an idea of ​​whether there is meconium there);
• The state of blood flow from the placenta to the fetus and from the uterus to the placenta;
• The degree of density of the baby’s cranial bones;
• Condition of the fontanelles.

Based on the results of the examination, which is carried out at 41–42 weeks of pregnancy, a decision is made on whether it is worth waiting for a natural birth or whether it is necessary to take some measures (stimulation or cesarean section).

Body changes and new sensations for women

On the mother's side, there may be some signs that indicate a post-term pregnancy. These include:

• decreased amount of amniotic fluid (can be determined by ultrasound);
• abdominal circumference decreases by 5–10 cm;
• the skin of the abdomen becomes flabby;
• a pregnant woman can lose more than 1 kg.

However, many of the listed symptoms often apply to normal pregnancy, so only a good specialist can accurately determine the mother’s condition. In any case, there is no need to panic and stress yourself out at 42 weeks: more than 90% of children born at this time do not experience major health problems.

Feelings of the expectant mother

The last weeks of pregnancy are particularly difficult. Fatigue, hormonal changes and worry about the baby make a woman whiny and irritable. At such a moment, the expectant mother needs the care and attention of loved ones more than ever.

Changes also occur in the pregnant woman's body:

• The abdomen becomes smaller, which is a consequence of a decrease in the volume of amniotic fluid and the lowering of the fetal head.
• The movements are felt less often, but more intense than before.
• The mammary glands become enlarged and heavier, and colostrum begins to be released from the nipples. The areolas become darker.
• The cervix shortens and smoothes out.
• I am worried about pain in the legs and in the area of ​​the pubic symphysis.
• A mucous discharge with blood streaks may appear, which indicates the plug is coming out.

On a note! Swelling in the legs at 42 weeks of pregnancy occurs in 60% of women.

Weight gain

There are no significant changes in this issue compared to other weeks. The woman no longer recovers; on the contrary, she may lose 1–2 kg (this is due to the loss of fluid by the tissues on the eve of childbirth).

Due to the large belly at 42 weeks, the mother is constrained in her movements and cannot completely relax. Or maybe psycho-emotional stress is the reason that the child has not yet been born? Talk, as psychologists advise, to your “tummy” and ask your baby to “speed up.”

What happens to the baby

At 42 weeks, the baby’s weight is approximately 3500-3800 g, and its height reaches 53-55 cm. Boys, as a rule, are 50-100 g heavier than girls and 3-4 cm taller. These data are approximate and it often happens that girls are born at a fairly high weight.

During this period, the baby continues to grow, although now it is not so intense. Exactly 40 weeks ago, a female cell was fertilized, giving rise to a new life. Considering that the fetus is already quite large, doctors insist that the birth take place in the near future.

The baby's head has already dropped and now fits tightly to the pelvic bones of the pregnant woman. The small body actively produces stress hormones. This is necessary for the baby to more easily cope with the birth and overcome a difficult period. It is very dangerous if hardening of the skull bones occurs during this period. For comfortable passage through the birth canal, they must remain mobile.

During an ultrasound, the doctor may discover that the fetus in the mother's womb is suffering. His skin becomes wrinkled, and there is not enough vernix lubrication. Overgrown nails appear on the hands, with which the baby often scratches himself. Due to insufficient oxygen, the baby may become overly active.

We invite you to find out now all the details of the development of girls and boys after birth and up to one year. All the necessary information is in our article.

Beauty and accessories

At 42 weeks, you may be unhappy with your appearance, which is quite natural - you are very tired (both mentally and physically) and are waiting for your baby to be born literally every hour. Take a break from such thoughts for a moment and take into account a few simple tips on how to restore your figure after childbirth. We hope they will help you in the future.

1. Breastfeed your baby! Long-term breastfeeding will help ensure the restoration of the endocrine system, but a sudden “abandonment” leads, according to many experts, to hormonal disruption.
2. Never forget that you are not only a mother, but also a woman! Take care of yourself, do light exercises, use your free time (of course, it will be little) for the benefit of yourself and your body.
3. Shift some of the responsibilities to the child's father! If possible, do not get carried away with the role of mother-heroine: in order to look good and recover faster, you need to at least occasionally rest and get a good night's sleep.

Have an easy birth! And a healthy, strong, charming baby (or little girl)!

Recommendations

At the 41st - 42nd week of pregnancy, you need to take a break from waiting for the onset of labor and lead a normal lifestyle. Be more active: walk in the fresh air, walk up the stairs, do swimming, gymnastics and do not give up your intimate life. During this period, it is important to continue to monitor changes in your weight, because not only extra pounds, but also lack of body weight negatively affects the child.

If at 41–42 weeks of pregnancy you experience digestive problems (constipation, diarrhea, dysbacteriosis), a healthy diet and daily routine will help. Eat often, but in small portions, eat more foods rich in plant fiber. These are cereals, vegetables, fruits, wholemeal bread. And fermented milk products contain probiotics, protein and calcium, so you should definitely have cottage cheese, kefir, yogurt and natural yoghurt on your table.

The moment when you will see your long-awaited baby is just around the corner. And to speed up its birth, you can use safe methods of self-stimulation of labor at 42 weeks of pregnancy:

• Nipple massage. If you do it three times a day for 15 minutes, the level of oxytocin in the blood, a hormone that stimulates labor, will significantly increase;
• Sexual intercourse. Orgasm promotes contraction of the uterine muscles, and sperm contains prostaglandins, which help soften the cervix and contract its muscles. Therefore, intimacy at 41–42 weeks of pregnancy is not only allowed, but recommended by doctors.

Natural methods of stimulation

If labor has not occurred at 42 weeks of pregnancy, but the woman feels fine and doctors say that there is no cause for concern yet, you can try natural methods of stimulation. When labor is induced by medication, labor often occurs quickly and painfully, which can negatively affect the well-being of the mother.

Castor oil and raspberry leaves are used to stimulate labor.

The advantages of “home” stimulation methods are that they are safe and can be used at any appropriate time. These include:

1. Physical exercise. A woman who is tired from pregnancy is advised to take more walks and walk up and down the stairs. While walking, the fetus puts pressure on the cervix, promoting its dilation.
2. Nipple stimulation. When rubbed, the hormone oxytocin is activated, causing increased uterine contractions. To do this, place your palm on top of the breast and begin rotational movements, after 15 minutes move to the other breast, and repeat the procedure when completed. The duration of the massage should be at least an hour, 3 times a day.
3. Sex. Male sperm contains prostaglandins that soften the cervix. And orgasm and the release of oxytocin in a woman’s body helps to increase uterine activity.
4. Castor oil. Laxatives act indirectly - they only activate intestinal motility, which in turn provokes contractile activity of the uterus.
5. Raspberry leaves. To prepare the decoction, add 1 tsp. dry leaves 1 cup boiling water, leave for 40 minutes. Strain the finished infusion and take orally 2-3 times during the day.

If you reach the 42nd week of pregnancy and there are still no signs of labor, it is recommended to consult a doctor and go to hospital. If the obstetrician-gynecologist has suspicions, a decision may be made to perform a cesarean section or labor stimulation. If there are no risks for the mother and fetus, it is allowed to carry out stimulation independently, in safer and more enjoyable ways.

When is a caesarean section performed?

What to do if at 42 weeks of pregnancy no signs of labor appear, and stimulation methods did not have the desired effect? In this case, the doctor may decide on surgical delivery.

Indications for caesarean section at 42 weeks of pregnancy may include:

1. The size of the fetus at the first birth is more than 4.5 kg.
2. Immaturity of the cervix.
3. Rupture of the uterus along the scar.
4. Acute fetal hypoxia.
5. Scar on the uterus after surgery or caesarean section.
6. The age of the woman in labor - after 30 years, the elasticity of the vaginal muscles deteriorates in women.
7. Absence of labor - if after 16-18 hours the cervix still opens slowly.
8. Transverse position of the fetus.
9. Narrow pelvis - this diagnosis is made when the fetus is large or the mother is weak in labor.
10. Post-term pregnancy in combination with one of the pathologies.

Possible problems

• Low hydramnios and decreased mobility of the skull bones (hardening). These signs indicate that the baby may be born post-term. An insufficient amount of amniotic fluid disrupts the conditions of existence of the fetus in utero. His skin begins to dry out, which will cause a lot of trouble for his mother after birth. And the mobility of the bones that make up the skull ensures favorable passage of the baby through the birth canal. Hardening of the bones can impede the advancement of the fetus and also lead to painful ruptures in the mother. In this case, doctors usually perform a caesarean section.
• Aging of the placenta with subsequent fetal hypoxia. During pregnancy, the placenta matures, providing the baby with the necessary amount of oxygen and nutrients at certain stages of development. Towards the end of pregnancy, she ages, and this is a natural process necessary for the placenta to separate from the wall of the uterus during childbirth. However, if the baby’s place no longer fulfills its functions due to aging, and the child has not yet been born, he may begin to lack, first of all, oxygen. And then hypoxia can begin. And if it is not detected in a timely manner, the baby can suffer greatly. That is why a pregnant woman is recommended to monitor the number of fetal movements during the day, a change in the number of which (a significant increase or decrease) indicates a deterioration in the baby’s well-being. This can be confirmed using CTG. If hypoxia develops, emergency delivery will be required.
• 42 weeks of pregnancy, the cervix is ​​not ready for childbirth. Cervical ripening occurs closer to childbirth. It shortens, softens and opens, allowing the fruit to come out. But it happens that even at this time there are no signs of ripening. In this case, depending on the condition of the pregnant woman and her baby, doctors choose a tactic that will lead to the birth of a healthy child. The cervix may be affected by substances contained in algae. In hospitals, they can use sticks made from such algae, which accelerate the ripening of the cervix. They are inserted inside, after which they swell and even partially open the neck. In some cases, medication cannot be avoided. There are drugs that specifically target the cervix. Not all pregnant women are ready to take pills, justifying this by not wanting to harm their baby. However, in this situation, this may be the best way out, because if the problem is only in the cervix, then after taking the pill you will be able to give birth naturally, avoiding surgical intervention. But in some cases, a caesarean section is simply necessary so that neither the woman nor the baby are harmed. Therefore, do not take the situation to the extreme by refusing pills or a cesarean section, because doctors make a decision by assessing your situation as a whole.
• Bleeding. It mainly occurs when placental abruption occurs. This situation can cost the life of the child and his mother, which is understandable. The placenta is nourished by vessels that “grow” into the wall of the uterus. And, accordingly, the uterine artery departs from the aorta. What conclusion does this suggest? If ruptures occur in the vessels through which the baby's place is connected to the wall of the uterus, severe bleeding may occur due to high pressure in these vessels. But we hasten to reassure you. This situation is dangerous when the percentage of detachment is large. In other cases, if you did not ignore the bleeding, you were quickly taken to the hospital and this problem was confirmed, the doctors will be able to help you. That is why, throughout pregnancy, gynecologists recommend avoiding heavy exertion, prohibiting carrying heavy objects and asking to monitor discharge.
• Preeclampsia. This is another problem that requires careful monitoring. If the first signs were detected on time, then there is no serious danger to the health of the pregnant woman. What is gestosis characterized by? This is a sharp increase in pressure, the development of external and internal edema, which can be seen by rapid weight gain, as well as protein in the urine. At the antenatal clinic, doctors can prescribe medications aimed at lowering blood pressure and recommend resting more often with elevated legs and reducing the amount of salt in the diet. Most often, a pregnant woman is sent to a hospital, where she will be monitored around the clock. Accordingly, if gestosis develops, all necessary measures will be taken.

Why are there no signs of imminent labor?

Signs of imminent onset of labor:

• increased frequency of training contractions;
• nagging pain in the lower abdomen and lower back;
• pain in the sacrum and pelvis due to bone separation;
• discharge of the mucus plug;
• mood swings, tearfulness;
• nesting syndrome;
• prolapse of the abdomen.

If you are in the 42nd week of pregnancy and there are no warning signs, this does not always indicate the presence of pathology, because the body of each expectant mother is individual. The listed signs may be due to hereditary characteristics of pregnancy or absent due to a sedentary lifestyle. Often, warning signs do not appear in repeat pregnancies.

There may be no signals about imminent labor in the last weeks due to incorrect presentation of the fetus or its entanglement with the umbilical cord. Hormonal imbalance in the body of a pregnant woman, inflammatory and infectious processes, tumors in the pelvic area also prevents the onset of labor and the appearance of signs preceding it.

In what cases is medical intervention required?

Since post-term pregnancy is dangerous for the baby and the expectant mother, it requires increased attention from doctors. Medical assistance is required if:

• water has been discharged, but labor does not occur;
• Ultrasound and CTG determine increasing fetal hypoxia;
• the baby's presentation is incorrect;
• the child is very large;
• the pregnant woman's birth canal is too narrow;
• amnioscopy reveals a significant decrease in the volume and color of amniotic fluid, and an admixture of meconium;
• labor is weak and does not lead to dilatation of the cervix.

Stimulation methods

If the doctors’ opinion about the need for childbirth at 42 weeks is confirmed, the degree of maturity of the cervix is ​​determined using the Bishop system. If the uterine pharynx has dilated by 1-2 fingers, and the examination result is 6-10 points, this indicates that the cervix is ​​ripe and labor will begin soon.

If the cervix is ​​not mature enough, additional stimulation is required. There are several ways to induce labor at 42 weeks of pregnancy:

1. Administration of oxytocin using IVs. A direct indication for this method is weak labor. A certain amount of the hormone causes intense contractions, after which the IV is removed.

Important! A large dosage of oxytocin can lead to uterine rupture, therefore, if there is no positive effect, after administering the required dose, a caesarean section is performed.

1. Use of prostaglandins. They are administered intramuscularly or used in gel form. The hormone provokes uterine contractions and helps soften the cervix. In most cases, the appearance of contractions is recorded 2-3 hours after stimulation. If this does not happen, after 6 hours the manipulation is repeated.
2. Use of Mifepristone. This is the name of the drug that blocks progesterone receptors, which stimulates uterine contractility.
3. Opening of the amniotic sac. The discharge of amniotic fluid causes uterine contractions. This method is performed only when the cervix is ​​dilated.
4. Introduction of laminaria into the cervical canal of a woman in labor. In it, the algae are saturated with moisture and increase in size (approximately 3-5 times per day), which contributes to the dilation of the cervix.

Causes of late labor

Prolonged pregnancy

In one out of ten cases, the gestation period extends to 42 weeks. If at this stage the pregnancy proceeds absolutely normally and without any signs of postmaturity, it will be called prolonged. The placenta does not lose its functions and ensures the supply of oxygen and nutrients, and the baby feels great. By prolonging such a pregnancy, there are no risks for the child and mother, but sufficient time is given for the final formation of internal organs and systems.

In case of prolonged pregnancy, consultation with a doctor is necessary.

There are a number of reasons why labor does not begin at 42 weeks:

• The duration of the menstrual cycle is more than 28 days.
• Hereditary factor.
• History of hormonal imbalances.
• The age of the expectant mother is over 30-35 years.
• First birth.
• Treatment during current pregnancy due to the threat of premature birth.

On a note! In case of prolonged pregnancy, you should consult a doctor and make sure that there are no risks for the fetus and the pregnant woman.

Post-term pregnancy

Only in 1-3% of situations is pregnancy considered post-term. The cause of childbirth at 42 weeks of pregnancy is usually health problems of the expectant mother:

1. Increased blood glucose levels.
2. Previous artificial termination of pregnancy.
3. Disturbances of the endocrine system.
4. Toxicosis, gestosis.
5. Lack of biological readiness of a pregnant woman’s body for labor – this may be due to a disruption in the functioning of the central nervous system of the mother or child, or psychological trauma. Many women are so afraid of the upcoming birth and pain that the body stops producing the necessary hormones.
6. Immaturity of the natural defenses of the fetus.
7. Heavy weight of the child.
8. Sedentary lifestyle of the mother: the fetal head does not descend into the pelvis and does not excite the receptors of the cervix.
9. Diseases of the urinary system.
10. Pathologies of the gastrointestinal tract.

Important! Bloody discharge can signal placental abruption; if detected, the woman needs to immediately call an ambulance.

What is the danger?

It happens that the 42nd week of pregnancy has already arrived, and labor does not begin. In this case, it is necessary to consult a doctor, since post-term pregnancy may cause a deterioration in the condition of the mother or child.

For a child

What are the dangers of childbirth at 41-42 weeks of pregnancy for a baby:

1. Oxygen starvation due to deterioration in the functioning of the placenta.
2. Difficulty in moving the baby through the birth canal due to the lack of cheese-like lubrication and dry skin.
3. Severe jaundice is an increased concentration of bilirubin in the blood, which is manifested in icteric staining of the skin and mucous membranes.
4. Meconium aspiration syndrome due to the entry of meconium into the child’s respiratory organs with blockage of the lumen of the lungs. This can happen if the baby takes his first breath in utero (although normally this should happen after birth) and swallows the original feces. To prevent complications, antibacterial therapy and artificial ventilation are carried out.
5. Increased likelihood of injury to soft tissues, bones and internal organs. Damage to the central nervous system is considered the most severe; the consequences can be convulsions, tremors of the limbs, neuroses, impaired thermoregulation of the body, as well as swallowing and sucking reflexes.

Particularly dangerous is a post-term pregnancy with a scar on the uterus left from a previous delivery or surgery. In this case, complications may arise:

• Bleeding in the postpartum period.
• Fetal asphyxia, accompanied by impaired placental circulation.
• Weakness of labor.
• Uterine rupture.
• Premature leakage of amniotic fluid.

For woman

If labor does not begin at the 42nd week of pregnancy, this may result in negative consequences for the woman in labor. Every day the fetus becomes larger in size, the bones of the head harden. If a woman has a clinically narrow pelvis, this adds additional complications.

Possible consequences of post-term pregnancy for a woman:

• Weak labor. If the fetus is large, surgical delivery is prescribed. If a woman decides to give birth on her own, there are risks of numerous ruptures and bleeding. The birth process can last about a day.
• Perineal incisions - if it is difficult for the child to pass through the birth canal.
• Injury to soft tissues and pelvic bones.
• Ruptures of the vagina, perineum and cervix, which may be due to the large size of the fetus and hardening of the bones.
• Postpartum hemorrhage.