Skip to main content
SpringerLink
Log in

Terminüberschreitung und Übertragung der Schwangerschaft

  • Chapter
  • First Online:
Die Geburtshilfe

Part of the book series: Springer Reference Medizin ((SRM))

Zusammenfassung

Eine Überschreitung der regulären Schwangerschaftsdauer von 280 Tagen post menstruationem kommt in ca. 36 % der Schwangerschaften vor. In Abhängigkeit vom Grad der Überschreitung entstehen hieraus 2 mögliche Risikoszenarien: Bei ausreichender Reservekapazität der Plazenta entwickelt sich bei weiterem Wachstum des Fetus möglicherweise eine Makrosomie mit potenziellen Komplikationen beim Geburtsverlauf für Mutter und Kind. Reichen hingegen die Reserven der Plazenta nicht aus, droht eine intrauterine Hypoxie mit z. T. irreversiblen Folgen bis hin zum intrauterinen Fruchttod.

Eine Schwangerschaftsbeendigung wird deshalb ab einer Terminüberschreitung um 7 Tage empfohlen, wobei das mütterliche Alter, die Parität und der BMI der Mutter mit zu berücksichtigen sind. Ab einer Schwangerschaftsdauer von 294 Tagen besteht wegen des steil ansteigenden Risikos für den Fetus eine Indikation zur Schwangerschaftsbeendigung.

Ein fetales Monitoring wird ab einer Terminüberschreitung von 7 Tagen empfohlen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  • ACOG Practice Bulletin No 55 (2004) Management of postterm pregnancy. Obstet Gynecol 104:639–646

    Article  Google Scholar 

  • Alexander JM, McIntyre DD, Leveno KJ (2000) Forty weeks and beyond: pregnancy outcomes by week of gestation. Obstet Gynecol 96:291–294

    CAS  PubMed  Google Scholar 

  • Alfirevic Z, Walkinshaw SA (1995) A randomized controlled trial of simple compared with complex antenatal fetal monitoring after 42 weeks of gestation. Br J Obstet Gynaecol 102:638–643

    Article  CAS  PubMed  Google Scholar 

  • Allott HA, Palmer CR (1993) Sweeping the membranes: a valid procedure in stimulating the onset labor? Br J Obstet Gynaecol 100:898–903

    Article  CAS  PubMed  Google Scholar 

  • AQUA Bundesauswertung zum Erfassungsjahr (2011) 16/1 Geburtshilfe Basisauswertung 2012:1–106. http://www.sqg.de/downloads/Bundesauswertungen/2011/bu_Gesamt_16N1-GEBH_2011.pdf. Zugegriffen im Januar 2014

  • Baschat AA, Gembruch U (2003) The cerebroplacental Doppler ratio revisited. Ultrasound Obstet Gynecol 21:124–127

    Article  CAS  PubMed  Google Scholar 

  • Baskett TF, Nagele F (2000) Naegele’s rule: a reappraisal. Br J Obstet Gynaecol 107:1433–1435

    Article  CAS  Google Scholar 

  • Berghella V, Rogers RA, Lescale K (1996) Stripping of membranes as a save method to reduce prolonged pregnancies. Obstet Gynecol 87:927–931

    Article  CAS  PubMed  Google Scholar 

  • Berle P, Misselwitz B, Scharlau J (2003) Mütterliche Risiken für eine Makrosomie, Inzidenz von Schulterdystokie und Plexus-brachialis-Parese. Z Geburtsh Neonatol 207:148–152

    Article  CAS  Google Scholar 

  • Boulvain M, Stan CM, Irion O (2005) Membrane sweeping for induction of labour. Cochrane Database Syst Rev (1). Art. No. CD000451. doi: 10.1002/14651858.CD000451.pub2

    Google Scholar 

  • Boyd ME, Usher RH, McLean FH, Kramer MS (1988) Obstetric consequences of postmaturity. Am J Obstet Gynecol 158:334–338

    Article  CAS  PubMed  Google Scholar 

  • Campbell S, Chervenak FA (Hrsg) (1993) Ultrasound in obstetrics and gynecology, Bd 1. Little & Brown, Boston, S 305–310

    Google Scholar 

  • Caughey AB, Stotland NE, Washington AE et al (2007) Maternal and obstetric complications of pregnancy are associated with increasing gestational age at term. Am J Obstet Gynecol 196:155.e1–155.e6

    Article  Google Scholar 

  • Caughey AB, Nicholson JM, Washington AE (2008) First- vs second-trimester ultrasound: the effect on pregnancy dating and perinatal outcomes. Am J Obstet Gynecol 198:703.e1–703.e6

    Article  Google Scholar 

  • Cheng YW, Kaimal AJ, Snowden JM et al (2012) Induction of labor compared to expectant management in low-risk women and associated perinatal outcomes. Am J Obstet Gynecol 207:502.e1–502.e8

    Article  Google Scholar 

  • Cibils LA, Votta R (1993) Clinical significance of fetal heart rate patterns during labor IX: prolonged pregnancy. J Perinat Med 21:107–116

    Article  CAS  PubMed  Google Scholar 

  • Clement D, Schifrin BS, Kates RB (1987) Acute oligohydramnios in postdate pregnany. Am J Obstet Gynecol 157:884–886

    Article  CAS  PubMed  Google Scholar 

  • Cochrane Pregnancy and Childbirth Database (2) (1995)

    Google Scholar 

  • D'Antonio F, Patel D, Chandrasekharan N, Thilaganathan B, Bhide A (2013) Role of cerebroplacental ratio for fetal assessment in prolonged pregnancy. Ultrasound Obstet Gynecol 42:196–200

    Article  PubMed  Google Scholar 

  • Denison FC, Price J, Graham C et al (2008) Maternal obesity, length of gestation, risk of postdates pregnancy and spontaneous onset of labour at term. BJOG 115:720–725

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • DGGG (2006) Anwendung des CTG während Schwangerschaft und Geburt. AWMF-Leitlinie No 015/036 (Leitliniensammlung der DGGG)

    Google Scholar 

  • DGGG (2010) S1-Leitlinie „Vorgehen bei Terminüberschreitung und Übertragung“. DGGG und AG Materno-fetale Medizin (AGMFM), AWMF-Leitlinie No. 015/065

    Google Scholar 

  • Divine PA, Brazero LA, Lysikiewicz A, Evans R, Womack S, Byrne DW (1994) Middle cerebral to umbilical artery Doppler ratio in postdate pregnancies. Obstet Gynecol 84:856–860

    Google Scholar 

  • Divon MY, Ferber A, Nisel H, Westgren M (2002) Male gender predisposes to prolongation of pregnancy. Am J Obstet Gynecol 187:1081–1083

    Article  PubMed  Google Scholar 

  • Divon MY, Ferber A, Sanderson M, Nissel H, Westgren M (2004) A functional definition of prolonged pregnancy. Ultrasound Obstet Gynecol 23:423–426

    Article  CAS  PubMed  Google Scholar 

  • Eden RD, Gergely RZ, Schifrin BS, Wade ME (1982) Comparison of antepartum testing schemes for management of the postdate pregnancy. Am J Obstet Gynecol 144:683

    Article  CAS  PubMed  Google Scholar 

  • European Resuscitation Council (2010) Guidelines for resuscitation. Section 1. Executive summary. Resuscitation 10:1219–1276

    Google Scholar 

  • Fox H (1979) The placenta as a model for organ ageing. In: Baconsfield P, Villee C (Hrsg) Placenta – a neglected experimental animal. Pergamon, Oxford, S 351–378

    Google Scholar 

  • Goeree R, Hannah M, Hewson S (1995) Cost-effectiveness of induction of labour versus serial antenatal monitoring in the Canadian Multicenter Postterm Pregnancy Trial. CMAJ 152:1445–1450

    CAS  PubMed  PubMed Central  Google Scholar 

  • Grant JM (1993) Sweeping of the membranes in prolonged pregnancy. Br J Obstet Gynaecol 100:889–890

    Article  CAS  PubMed  Google Scholar 

  • Gülmezoglu AK et al (2006) Induction of labor for improving birth outcome for women at or beyond term (Cochrane Review). The Cochrane Library (4)

    Google Scholar 

  • Hadlock FH, Harrist RB, Fearneyhouhg TC, Deter RL, Bark SK, Rossavik IK (1985) Use of femur length – abdominal circumference ratio in detecting the macrosomic fetus. Radiology 154:503–505

    Article  CAS  PubMed  Google Scholar 

  • Hannah ME, Hannah WJ, Hellmann J, Hewson S, Milner R, Willan A (1992) Induction of labor as compared with serial antenatal monitoring in post-term pregnancy: a randomized controlled trial. N Engl J Med 326:1587–1592

    Article  CAS  PubMed  Google Scholar 

  • Henriksen TB, Wilcox AJ, Hedegaard M, Secher NJ (1995) Bias in studies of preterm and postterm delivery due to ultrasound assessment of gestational age. Epidemiology 6:533–537

    Article  CAS  PubMed  Google Scholar 

  • Kistka ZA, Palomar L, Boslaugh SE, DeBaun MR, DeFranco EA, Muglia LJ (2007) Risk for postterm delivery after previous postterm delivery. Am J Obstet Gynecol 196:241.e1–241.e6

    Article  Google Scholar 

  • Levine AB, Lockwood CJ, Brown B, Lapinski R, Berkowitz RL (1992) Sonographic diagnosis of the large for gestational age fetus at term: does it make a difference? Obstet Gynecol 79:55–58

    CAS  PubMed  Google Scholar 

  • Loytved C, Bosch C, Berger C, Gutjahr K (2009) Was meinte Naegele mit seiner Regel? Hebamme 22:142–148

    Article  Google Scholar 

  • Macri CJ, Schrimmer DB, Leung A, Greenspoon JS, Paul RH (1992) Prophylactic amnioninfusion improves outcome of pregnancy complicated by thick meconium and oligohydramnions. Am J Obstet Gynecol 167:117–121

    Article  CAS  PubMed  Google Scholar 

  • Mandujano A, Waters TP, Myers SA (2013) The risk of fetal death: current concepts of best gestational age for delivery. Am J Obstet Gynecol 208(207):e1–e8

    PubMed  Google Scholar 

  • Manning FA, Blatt LG, Sipos L (1980) Antepartum fetal evaluation. Development of a fetal biophysical profile score. Am J Obstet Gynecol 136:787–795

    Article  CAS  PubMed  Google Scholar 

  • Mannino F (1988) Neonatal complications of postterm gestation. J Reprod Med 33:271–276

    CAS  PubMed  Google Scholar 

  • Martin JA, Hamilton BE, Ventura SJ, Osterman MJK, Mathews TJ (2013) Births: final data for 2011. National vital statistics reports, vol 62, No 1. National Center for Health Statistics, Division of Vital Statistics (USA)

    Google Scholar 

  • McLean SH, Boyd ME, Usher RH, Kramer MS (1991) Postterm infants: too big or too small. Am J Obstet Gynecol 164:619–624

    Article  CAS  PubMed  Google Scholar 

  • McLean A, Bisiets A, Davies J, Woods R, Lawry P, Smith R (1995) A placental clock controlling the length of human pregnancy. Nat Med 1:460–463

    Article  CAS  PubMed  Google Scholar 

  • Menticoglu SM, Hall PF (2002) Routine induction of labour at 41 weeks gestation: nonsensus consensus. BJOG 109:485–491

    Article  Google Scholar 

  • Mittendorf R, Williams MA, Berkey CS, Cotter PF (1990) The length of uncomplicated human gestation. Obstet Gynecol 75:929–932

    CAS  PubMed  Google Scholar 

  • Mittendorf R, Williams MA, Berkey CS, Lieberman E, Monson RR (1993) Predictors of human gestational length. Am J Obstet Gynecol 168:480–484

    Article  CAS  PubMed  Google Scholar 

  • Miyazaki FS, Miyazaki BA (1981) False reactive non-stress test in postterm pregnancies. Am J Obstet Gynecol 140:269

    Article  CAS  PubMed  Google Scholar 

  • Mogren I, Stenlund H, Hogberg U (1999) Recurrence of prolonged pregnancy. Int J Epidemiol 28:253–257

    Article  CAS  PubMed  Google Scholar 

  • Morris JM, Thompson K, Smithey J, Gaffney G, Cooke I, Chamberlain P, Hope P, Altman D, MacKenzie IZ (2003) The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study. BJOG 110:989–994

    Article  CAS  PubMed  Google Scholar 

  • National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units (1994) A clinical trial of induction of labor versus expectant management in postterm pregnancy. Am J Obstet Gynecol 170:716–723

    Article  Google Scholar 

  • O’Reilly-Green C (1996) Positive and negative predictive value of estimated fetal weight for macrosomia in postdates patients. Am J Obstet Gynecol 174:350

    Google Scholar 

  • Olesen OW, Basso O, Olsen J (2003) Risk of recurrence of prolonged pregnancy. Br Med J 326:476

    Article  Google Scholar 

  • Oz AU, Holub B, Mendilcioglu I, Mari G, Bahado-Singh RO (2002) Renal artery Doppler investigation of the etiology of oligohydramnios in postterm pregnancy. Obstet Gynecol 100:715–718

    CAS  PubMed  Google Scholar 

  • Palacio M, Figueras F, Zamora L, Jiménez JM, Puerto B, Coll O, Cararach V, Vanrell JA (2004) Reference ranges for umbilical and middle cerebral artery pulsatility index and cerebroplacental ratio in prolonged pregnancies. Ultrasound Obstet Gynecol 24:647–653

    Article  CAS  PubMed  Google Scholar 

  • Phelan JP, Platt LD, Yeh SY, Broussard P, Paul RH (1985) The role of ultrasound assessment of amniotic fluid volume in the management of postdate pregnancy. Am J Obstet Gynecol 151:304–308

    Article  CAS  PubMed  Google Scholar 

  • Phelan JP, Smith CV, Broussard P, Small M (1987) Amniotic fluid volume assessment with the 4-quadrant technique at 36 to 42 weeks gestation. J Reprod Med 32:540

    CAS  PubMed  Google Scholar 

  • Pollack RN, Hauer-Pollack G, Divon MY (1992) Macrosomia in postdates pregnancies: the accuracy of routine ultrasonographic screening. Am J Obstet Gynecol 167:7–11

    Article  CAS  PubMed  Google Scholar 

  • Rand L, Robinson JN, Economy KE, Norwitz ER (2000) Post-term induction of labor revisited. Obstet Gynecol 96:779–783

    CAS  PubMed  Google Scholar 

  • Reddy UM, Ko CW, Willinger M (2006) Maternal age and the risk of stillbirth throughout pregnancy in the United States. Am J Gynecol Obstet 195:764–770

    Article  Google Scholar 

  • Romero R, Jeanty P (1984) Obstetrical ultasound. McGraw-Hill, New York

    Google Scholar 

  • Rosen MG, Dickinson JC (1992) Management of post-term pregnancy. N Engl J Med 326:1628–1629

    Article  CAS  PubMed  Google Scholar 

  • Royal College of Obstetricians and Gynaecologists (2008) Induction of labour. Clinical Guideline July 2008. National Collaborating Centre for Women’s and Children’s Health. RCOG Press London.

    Google Scholar 

  • Roweland S, Royston B (1993) Estimated date of delivery from last menstrual period and ultrasound scan: which is more accurate? Br J Gen Pract 43:322–325

    Google Scholar 

  • Sanchez-Ramos L, Bernstein S, Kaunitz AM (2002) Expectant management versus labor induction for suspected fetal macrosomia: a systematic review. Obstet Gynecol 100:997–1002

    Article  PubMed  Google Scholar 

  • Sanders N, Patterson C (1991) Effect of gestational age on obstetrics performance: When is "term" over? Lancet 338:1190–1192.

    Article  Google Scholar 

  • Santolaya-Forgas J, Meyer WJ, Gauthier DW, Kahn D (1994) Intrapartum fetal subcutaneous tissue-femur length ratio: an ultrasonographic clue to fetal macrosomia. Am J Obstet Gynecol 171:1072–1075

    Article  CAS  PubMed  Google Scholar 

  • SGGG (2002) Überwachung und Management bei Überschreitung des Geburtstermins. Gynäkol Geburtshilfliche Rundsch 42:166–170

    Article  Google Scholar 

  • Shime J, Librach CL, Gare DJ, Cook CJ (1986) The influence of prolonged pregnancy on infant development at one and two years of age: a prospective controlled study. Am J Obstet Gynecol 154:341–345

    Article  CAS  PubMed  Google Scholar 

  • Smith GCS (2001) Life-table analyses of the risk of perinatal death at term and post term in singleton pregnancies. Am J Obstet Gynaecol 184:489–496

    Article  CAS  Google Scholar 

  • Spellacy WN, Miller S, Winegar A, Peterson PQ (1985) Macrosomia – maternal characteristics and infant complications. Obstet Gynecol 66:158–161

    CAS  PubMed  Google Scholar 

  • Veille JC, Penry M, Mueller-Heubach E (1993) Fetal renal pulsed Doppler waveform in prolonged pregnancies. Am J Obstet Gynecol 169:882–884

    Article  CAS  PubMed  Google Scholar 

  • Vorherr H (1975) Placental insufficiency in relation to postterm pregnancy and fetal postmaturity. Evaluation of fetoplacental function; management of the postterm gravida. Am J Obstet Gynecol 123:67–103

    Article  CAS  PubMed  Google Scholar 

  • Weiner Z, Farmakides G, Schulman H, Kellner L, Plancher S, Maulik D (1994) Computerised analysis of fetal heart rate variation in postterm pregnancy: prediction of intrapartum fetal distress ans fetal acedosis. Am J Obstet Gynecol 171:1132–1138

    Article  CAS  PubMed  Google Scholar 

  • Weiner Z, Farmakides G, Schulman H, Casale A, Itskovitz-Eldor J (1996) Central and peripheral hemodynamic changes in postterm fetuses: correlation with oligohydramnions and abnormal fetal heart rate pattern. Br J Obstet Gynaecol 103:541–546

    Article  CAS  PubMed  Google Scholar 

  • Weiss E, Krombholz K, Eichner M (2014) Fetal mortality at and beyond term in singleton pregnancies in Baden-Wuerttemberg/Germany 2004–2009. Arch Gynecol Obstet 289(1):79–84

    Article  PubMed  Google Scholar 

  • Whitworth M, Bricker L, Neilson JP, Dowswell T (2010) Ultrasound for fetal assessment in early pregnancy. Cochrane Database Syst Rev 4, CD007058. doi:10.1002/14651858.CD007058.pub2

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinikum Sindelfingen-Böblingen, Klinikverbund Südwest, Frauenklinik und Perinatalzentrum Böblingen, Kliniken Böblingen, Bunsenstr. 120, 71032, Böblingen, Deutschland

    Erich Weiss

  2. Universitätsklinikum Tübingen, Frauenklinik, Calwerstr. 7, 72076, Tübingen, Deutschland

    Harald Abele

  3. Universitätsklinik für Frauenheilkunde, Inselspital, 3010, Bern, Schweiz

    Henning Schneider

Authors
  1. Erich Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Harald Abele
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Henning Schneider
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Erich Weiss .

Editor information

Editors and Affiliations

  1. Frauenklinik, Universitätsklinikum, Bern, Switzerland

    Henning Schneider

  2. Frauenklinik, Medizinische Universität Wien, Wien, Austria

    Peter Husslein

  3. Frauenklinik u. Poliklinik, TU, Klinikum Rechts d. Isar, München, Germany

    Karl-Theo M. Schneider

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Weiss, E., Abele, H., Schneider, H. (2016). Terminüberschreitung und Übertragung der Schwangerschaft. In: Schneider, H., Husslein, P., Schneider, KT. (eds) Die Geburtshilfe. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45064-2_33

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-45064-2_33

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-45063-5

  • Online ISBN: 978-3-662-45064-2

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation