The normal length of pregnancy is from 37 to 41 weeks. Postmaturity refers to any baby born after 42 weeks gestation or 294 days past the first day of the mother's last menstrual period. Less than 6 percent of all babies are born at 42 weeks or later. Other terms often used to describe these late births include post-term, postmaturity, prolonged pregnancy, and post-dates pregnancy. Show
It is not known why some pregnancies last longer than others. Postmaturity is more likely when a mother has had one or more previous post-term pregnancies. Sometimes a mother's pregnancy due date is miscalculated because she is not sure of her last menstrual period. A miscalculation may mean the baby is born earlier or later than expected. Postmature babies are born after the normal length of pregnancy. The placenta, which supplies babies with the nutrients and oxygen from the mother's circulation, begins to age toward the end of pregnancy, and may not function as efficiently as before. Other concerns include the following:
The following are the most common symptoms of postmaturity. However, each baby may show different symptoms of the condition. Symptoms may include:
Symptoms of postmaturity may resemble other conditions or medical problems. Always consult your baby's doctor for a diagnosis. Postmaturity is usually diagnosed by a combination of assessments, including the following:
Testing may be done for a post-term pregnancy to check fetal well-being and identify problems. Tests often include ultrasound, nonstress testing (how the fetal heart rate responds to fetal activity), and estimation of the amniotic fluid volume. The decision to induce labor for post-term pregnancy depends on many factors. During labor, the fetal heart rate may be monitored with an electronic monitor to help identify changes in the heart rate due to low oxygenation. Changes in a baby's condition may require a cesarean delivery. Special care of the postmature baby may include:
Accurate pregnancy due dates can help identify babies at risk for postmaturity. Ultrasound examinations early in pregnancy help establish more accurate dating by measurements taken of the fetus. Ultrasound is also important in evaluating the placenta for signs of aging. Each newborn baby is carefully checked at birth for signs of problems or complications. The healthcare provider will do a complete physical exam that includes every body system. Throughout the hospital stay, doctors, nurses, and other healthcare providers continually look at the health of the baby. They are watching for signs of problems or illness. Assessments may include the below. Apgar scoringThe Apgar score helps find breathing problems and other health issues. It is part of the special attention given to a baby in the first few minutes after birth. The baby is checked at 1 minute and 5 minutes after birth for heart and respiratory rates, muscle tone, reflexes, and color. A Each area can have a score of 0, 1, or 2, with 10 points as the maximum total. Most babies score 8 or 9, with 1 or 2 points taken off for blue hands and feet because of immature circulation. If a baby has a difficult time during delivery and needs extra help after birth, this will be shown in a lower Apgar score. Apgar scores of 6 or less usually mean a baby needed immediate attention and care.
Birth weightA baby's birth weight is an important marker of health. Full-term babies are born between 37 and 41 weeks of pregnancy. The average weight for full-term babies is about 7 pounds (3.2 kg). In general, very small babies and very large babies are at greater risk for problems. Babies are weighed every day in the nursery to look at growth, and the baby’s need for fluids and nutrition. Newborn babies may often lose 5% to 7% of their birth weight. This means that a baby weighing 7 pounds, 3 ounces at birth might lose as much as 8 ounces in the first few days. Babies will usually gain this weight back within the first 2 weeks after birth. Premature and sick babies may not begin to gain weight right away. Most hospitals use the metric system for weighing babies. This chart will help you convert grams to pounds. Converting grams to pounds and ounces:1 lb. = 453.59237 grams; 1 oz. = 28.349523 grams; 1,000 grams = 1 Kg.
MeasurementsThe hospital staff takes other measurements of each baby. These include:
The staff also checks these vital signs:
Physical examA complete physical exam is an important part of newborn care. The healthcare provider carefully checks each body system for health and normal function. The provider also looks for any signs of illness or birth defects. Physical exam of a newborn often includes:
Gestational assessmentThe healthcare provider will check how mature the baby is. This is an important part of care. This check helps figure out the best care for the baby if the dates of a pregnancy are uncertain. For example, a very small baby may actually be more mature than they appear by size and may need different care than a premature baby needs. Healthcare providers often use an exam called the Dubowitz/Ballard Examination for Gestational Age. This exam can closely estimate a baby's gestational age. The exam looks at a baby's skin and other physical features, plus the baby’s movement and reflexes. The physical maturity part of the exam is done in the first 2 hours of birth. The movement and reflexes part of the exam is done within 24 hours after birth. The provider often uses the information from this exam to help with other maturity estimates. Physical maturityThe physical maturity part of the Dubowitz/Ballard exam looks at physical features that look different at different stages of a baby's gestational age. Babies who are physically mature usually have higher scores than premature babies. Points are given for each area of assessment. A low of 1 or 2 means that the baby is very immature. A score of 4 or 5 means that the baby is very mature (postmature). These are the areas looked at:
Maturity of nerves and musclesThe healthcare provider does 6 checks of the baby's nerves and muscles. A score is given for each area. Typically, the more mature the baby is, the higher the score. These are the areas checked:
When the physical assessment score and the nerves and muscles score are added together, the healthcare provider can estimate the baby’s gestational age. Scores range from very low for immature babies to very high scores for mature and postmature babies. All of these exams are important ways to learn about your baby's well-being at birth. By finding any problems, your baby's healthcare provider can plan the best possible care. Which of the following symptoms would the nurse expect to observe in a newborn diagnosed with respiratory distress syndrome?Babies who have RDS may show these signs: Fast breathing very soon after birth. Grunting “ugh” sound with each breath. Changes in color of lips, fingers and toes.
Which normal findings are present in a healthy neonate quizlet?Normal findings begin with fontanels that are soft and flat, if present. Infantile reflexes are present but disappear during first year as infant's nervous system matures. Babinski's reflex is exception; it disappears by 18 months. Some head flexion normally present.
Which assessment findings will a nurse find in a newborn with meconium aspiration syndrome?Signs & symptoms
Grunting sounds with breathing. Bluish skin color, called cyanosis. Low apgar score, a rating of a baby's color, heartbeat, reflexes, muscle tone and respiration just after birth. Limp body.
What are the initial signs of pain anticipated in the neonate?Physical reactions to pain
Physiological indicators, including heart rate, breathing rate, blood pressure, skin colour, vomiting, sweating, and dilated or widened pupils, are also used to determine if a baby is in pain.
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When assessing a post term neonate Which of the following would the nurse expect to find?
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