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Obstetrical risks in the older primigravida.

Mehreen Mehdi Naqvi1, Azra Naseem

  • 1Department of Obstetrics and Gynaecology, POF Hospital, Wah Cantt.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|July 1, 2004
PubMed
Summary
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Elderly primigravidas face higher risks of pregnancy complications, including hypertension and diabetes, and are more likely to require cesarean delivery. Advanced maternal age necessitates careful monitoring for improved fetal outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Reproductive Health

Background:

  • Advanced maternal age (AMA) in primigravidas is associated with increased obstetric risks.
  • Understanding specific complications and outcomes is crucial for managing pregnancies in older first-time mothers.

Purpose of the Study:

  • To compare pregnancy complications, delivery modes, and fetal outcomes between elderly and young primigravidas.
  • To identify risks associated with advanced maternal age in first-time pregnancies.

Main Methods:

  • A comparative study design was employed.
  • 156 elderly primigravidas were compared with a matched group of younger primigravidas.
  • Data on antenatal, intrapartum, and postpartum complications, as well as perinatal mortality, were collected and analyzed using SPSS and Chi-square tests.

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Main Results:

  • Elderly primigravidas experienced significantly higher rates of pregnancy-induced hypertension, diabetes, malpresentation, and premature labor.
  • Cesarean section rates were higher in the elderly group (30.76% vs. 16.02%).
  • Congenital malformations and conditions like fibroid uterus and ovarian cysts were more frequent in elderly primigravidas, with higher perinatal mortality.

Conclusions:

  • Advanced maternal age is linked to increased risks of hypertension, diabetes, intrauterine growth retardation, and congenital malformations.
  • Timely diagnosis and management of complications are essential for favorable outcomes.
  • Higher cesarean section rates in older primigravidas are primarily due to increased obstetric complications.