[Pregnancy and delivery after the age of 40]

When pregnancy occurs in a woman who is more than 40 years of age there are certain risks, ranging from the risks of chromosome abnormalities to those associated with grand multiparity and the syndrome of "the precious baby", when it is a first pregnancy. We have looked at the case notes of 52 patients who delivered after the age of 40. This was a total of 59 pregnancies which occurred in our service between the 1st January 1981 and the 31st December 1986. Of these patients 6 were primiparous, which was 1.17% of all those women delivered in the service. 83% delivered vaginally, with or without the help of forceps. In this group hypertension as well as vein troubles and fatness are more common. Prematurity was of a low order (3.4%), as was perinatal mortality as compared with other series in the literature. We only had one case of trisomy and this was very upsetting for us because we could not get across to our patients the importance of antenatal screening in more than one third of all cases.