Obstetrical performance in elderly Zambian parturients

The Obstetrical performance of elderly parturients (aged 40 and above) who delivered at the University Teaching Hospital, Lusaka during 1979 and 1980, has been analysed. There were 39,109 deliveries in the two years period, out of which 391 mothers were of 40 years or above, giving an incidence of 1.0%. There were 32 mothers above the age of 45, an incidence of 0.08%. Analysis of these mothers revealed that 87.2% of them were grand multipara with maximum parity of 16. Incidence of breech, toxaemia, malpresentation and multiple pregnancy were observed in the series but there was no maternal death recorded in the present study. History of abortion in previous pregnancies ranging from 1 to 5 was noted in 43 cases. Operative deliveries were noted in 22% cases, out of which 13% were delivered by caesarean section and 9% had to undergo operative vaginal interference. In the foetal outcome, high rates of prematurity (71/1,000) and perinatal death (138/1,000) were noted. Relations of birth weights, age and parity of mothers with preventable factors are discussed.