[Late primiparity: what has changed in the last 25 years?]

The case reports of late primiparae greater than 35 years of age were analysed in respect of the change of anamnestic risks, of the course of pregnancy, birth and puerperium, as well as of infant data. The incidence of late primiparae rose in our clinic from A 1.8% (n = 292, infants n = 294), via B 2.6% (n = 210, infants n = 213) to C 3.7% (n = 222, infants n = 225.) Previous history of internistic diseases was rare during all periods. In period C, the anamnestic risk "Status after sterility treatment" attains increasing importance (17%). The incidence of pre-eclamptic toxaemia (toxaemia associated with oedema, proteinuria and hypertension) with blood pressure levels greater than 140/90 mgHg and proteinuria greater than 1 0/00 is 5-7% for all periods. Preeclampsia and eclampsia are rare. During the C period, almost every tenth late primigravida received tocolytics. In 1979, 31% of the late primiparae were subjected to genetic amniocentesis, whereas in 1982 the percentage was 51% of the late primiparae. Spontaneous deliveries decreased from 81% (A) to 50% (C). The rates of Caesarean sections increased from 11% (A) via 21% (B) to 35% (C); hence, they were twice as high during all periods than among the entirety of hospital patients included in this study. The increase in the quota of Caesarean sections is due to the indications "foetal distress ante partum", "breech presentation" and the liberal use of Caesarean section in underweight infants. For example, the category of newborn with a bodyweight below 2500 g, the rate of Caesarean sections increased from 7% (A) to 56% (C).(ABSTRACT TRUNCATED AT 250 WORDS)