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Category: Volume 05 Issue 10 October 2017
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Title: Outcome of Pregnancy in Elderly Primigravida

Authors: Dr Vasanthakumari K P, Prof. Dr Nandini Vamdevan Retnamma

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.176

Abstract

Abstract

Background: In India, the average age of marriage is 20-23 years and majority of women complete their families by the first half of their twenties. With improved health and education, increasing number of women in our state are postponing their first child. An elderly nulliparous woman is one who is aged 35 years or more. As age advances, there is a reduction in fertility. Women thirty five years or older have greater risk of diabetes, spontaneous abortions, hypertensive disorders, trisomies, caesarian births and maternal mortality. This study aims to measure the maternal complications, type of delivery, labor complications, fetal outcome in addition to socio-demographic factors.

Methods: This is a case control study. Elderly nulliparous women i.e.  35 years or above will be taken as case and those nulliparous women in the age group 20-29 years will be considered as control.

Results: Data collected are tabulated and analyzed using SPSS package.

150 nulliparous women in the age group of 35 years and above were taken as the study group and appropriately matched. 150 nulliparous women belonging to the age group of 20-29 were taken as control group. Both groups were identical with respect to religion. There was a threefold increased incidence of spontaneous abortions among study group as compared to control group. Among the study group, 24 percent underwent treatment for infertility where as only 5 percent in the control group had similar treatment. The incidence of antenatal complications were four times higher in the study group. The incidence of Caesarian section was 21 percent in the study group and 2 percent in the control group. Meconium stained liquor was 2 times higher in the study group. There was no difference in the incidence of postpartum complications in the two groups.

Conclusion

  1. Previous spontaneous abortions were found to be three fold higher in the study group as compared to the control group.
  2. Antenatal complications were four times higher in the study group as compared to the control group.
  3. Incidence of preeclampsia was four fold higher in the study group as compared to the control group.
  4. Incidence of anemia was three fold higher in the study group as compared to the control group.
  5. Incidence of gestational diabetes was seven times higher in the study group as compared to the control group.
  6. Incidence of elective Caesarian section was high in the study group (21% vs 2%).
  7. Incidence of neonatal complications was two times higher in the study group as compared to the control group.
  8. There was no difference in the incidence of postpartum complications in the two groups

Keywords: Elderly, Nulliparous, Preeclampsia, Gestational diabetes, Caesarian section, Abortions, Neonatal.

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Corresponding Author

Prof. Dr Nandini Vamdevan Retnamma

Professor, Dept. of O and G, SAT hospital,

Govt. Medical College, Trivandrum