A pregnancy reaching 42 completed weeks (294 days) is
defined as postterm (PT). The use of ultrasound in early
pregnancy for precise dating significantly reduces the number
of PT pregnancies compared to dating based on the last
menstrual period. Although the fetal, maternal and neonatal
risks increase beyond 41 weeks, there is no conclusive evidence
that prolongation of pregnancy, per se, is the major
risk factor. Other specific risk factors for adverse outcomes
have been identified, the most important of which are
restricted fetal growth and fetal malformations. In order to
prevent PT and associated complications routine induction
before 42 weeks has been proposed. There is no conclusive
evidence that this policy improves fetal, maternal and neonatal
outcomes as compared to expectant management. It is
also unclear if the rate of cesarean sections is different
between the two management strategies. After careful identification
and exclusion of specific risks, it would seem
appropriate to let women make an informed decision about
which management they wish to undertake. There is consensus
that the number of inductions necessary to possibly avoid
one stillbirth is very high. If induction is preferred, proce-