A 38-year-old woman, gravida 3, para 2, aborta 0, presents to the labour and delivery...

This patient has a post-term pregnancy (≥42 weeks’ gestation). Post-term pregnancies are associated with increased risks including placental insufficiency, oligohydramnios, meconium aspiration, fetal macrosomia, and stillbirth. During induction and labour in post-term pregnancies, continuous electronic fetal monitoring (EFM) is recommended to assess fetal well-being and detect signs of fetal distress early.

Prostaglandin induction is not contraindicated; it is commonly used for cervical ripening when indicated, provided there are no standard contraindications (e.g., prior classical cesarean). Cesarean delivery is not routinely preferred solely due to post-term status; mode of delivery should be based on obstetric indications.

According to MCCQE objectives, candidates must recognize the risks associated with post-term pregnancy and understand appropriate intrapartum management, including fetal surveillance. Continuous EFM is recommended in higher-risk situations such as post-term gestation to optimize perinatal outcomes while still aiming for safe vaginal delivery when no contraindications exist.