Prolonged Pregnancy timeline - Diagnosis

1. Medical history - the history is retained after the last menstrual period, when it movedfor the first time the fetus, if pregnant this regular or irregular menstrual cycles, if you had a single sexual intercourse, age data which is calculated after pregnancy. Also have to mention taking out third trimester of pregnancy.
2. Clinical examination of the mother - pregnant with extended chronologically real taskshows a false labor on time, and dyspnea disappeared upper abdominal discomfort intensifying pelvic discomfort, is well-formed lower segment, the cervix is ​​ripe, the baby is shaken to palpation and symphysis exceeds fetal skull. Active fetal movements become painful.
3. Clinical signs of fetal - to confirm the diagnosis of pregnancy suprapurtata clinical examination of the fetus after birth is very important. Thus, 60% of eutrophic fetuses are very sensitive but with a length of 53 cm. Adipose tissue is poorly represented until his disappearance complete new look is born alive and open (the sign of vigilance WOLF KIEL). Cliford describes the infant from a pregnancy suprapurtata as a small old man (LITTLE OLD MAN), with "hands and feet pursed, the washerwoman would like to borrow clothes."
 There are three degrees of postmaturitate (Ballantyne Runge fetal syndrome):- Grade I, in which the burden exceeds 300 days. The child is long, thin, without vernix, amniotic fluid volume is low but clear, opalescent;- Grade II, in which the duration of pregnancy exceeds 305 days. The baby is long, thin, wrinkled, impregnated with meconium, respiratory distress and sometimes shows hypoglycemia. Amniotic fluid is the least viscous, stained with meconium;- Grade III, the load exceeds 310 days. The fetus is greenish yellow skin, macerated, lung atelectasis shows respiratory distress. In some cases fetal distress may lead to fetal death.
 Paraclinical diagnosis
1. Diagnosis is made by placental insufficiency: amnioscopie determinationplacental flow (flow is very low if the cord which can cause fetal death intrauerina).2. Diagnosis of placental function is pharmaco-dynamic tests: testatropine (not so wrinkled tachycardia due to placenta) maternal exercise testing induces fetal tachycardia, the oxytocin test.3. Echography4. Fetal radiography5. Citohormonal hormonal examination and are indicative6. Amniocentesis7. Enzymatic investigations - as a result of cytolysis increases of serum transaminases hundreds maternal values ​​(TGO - 220UI, SGPT - 93 IU).
 Changes in fetal
 Placental flow reduction leads to fetal hypoxia and acidosis result in fetal. Fetal response to acidosis is the increase of fetal hemoglobin and hematocrit. Show fetal distress can lead to fetal death.