Prolonged pregnancy, defined as a pregnancy lasting more than 294 days from the date of the last menstrual period, is recognized as a high-risk problem faced by obstetricians. Perinatal morbidity and mortality are significantly increased and many obstetric units offer routine induction of labour, generally at 41–42 weeks of gestation, to overcome the adverse perinatal risks. Debate continues as to whether the policy of routine induction of labour is justified, particularly with an unfavourable cervix. Expectant management with serial fetal surveillance, while awaiting the onset of spontaneous labour, has been advocated as the alternative to routine induction of labour. The optimum method of fetal surveillance has not been identified. Nor is there consensus as to when antenatal fetal surveillance should begin, or how often these tests should be performed.
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