scholarly journals Obstetric outcome in elderly gravida

Author(s):  
Supriya S. Gaikwad ◽  
Kamlesh R. Chaudhari ◽  
Karuna Batheja

Background: Maternal age is an important determinant of the outcome of pregnancy. Advanced maternal age generally signify age after 35 years at the time of delivery. It is associated with decreased fertility and increased risk. Elderly gravida is associated with many complications during pregnancy, labour and also for the baby. In recent times women has changed their lifestyles such as pursuit of higher education and entry into work forces and career advancement outside the home.Methods: This was a retrospective study done in 57 elderly pregnant women more than 33 years age, over a period of 18 months, conducted in a multi-specialty hospital.Results: 57 elderly pregnant women were selected for the study. 47% were in age group of 33-35 years and 42% were in age group of 36-40 years. 61.40% patients were housewives and 38.59% were employed. 50.8% of patients had history of previous abortions and 35% were conceived after treatment for sterility. 64.9% of patients conceived spontaneously and 35% by assisted reproductive technology. Majority of patients (33.3%) required Invitro-fertilization. Multiple pregnancy was high- 21.05%. Hypertension was observed in 26.3% of patients, Antepartum haemorrhage in 4.34%,  Preterm delivery  49.1%, Induction of labour in 10.52%, Normal vaginal delivery only in14%. Majority of patients (80.7%) were delivered by caesarean section.Conclusions: Elderly pregnant patients have higher risks of specific pregnancy complications which contribute to a higher frequency of maternal morbidity and greater health care costs. The risks are due to Hypertension, diabetes, multiple pregnancy, preterm labour, antepartum haemorrhage, PROM, malpresentation, prolonged labour, increased caesarean section rate and postpartum haemorrhage.

2021 ◽  
Vol 15 (8) ◽  
pp. 2172-2174
Author(s):  
Hina Zubair ◽  
Amber-u-Nissa Soomro ◽  
Shafqat Mukhtar ◽  
Aurooj Fatima

Background: Miscarriages are negative outcomes of a pregnancy. Their ratio increases in women with recurrent miscarriages. Objective: To identify the role of age and recurrent miscarriages in spontaneous abortions. Study Design: Comparative analytical study Place and Duration of Study: Department of Obstetrics & Gynecology, Mohtarma Benazir Bhutto Medical College Mir Pur, Azad Kashmir from 1st October 2020 to 31st March 2021. Methodology: One hundred and twenty pregnant women between the age group of 19-40 years. The clinical history of recurrent miscarriages and demography was noted. Results: The mean age was 29.85±4.71 years with 42% of previous miscarriage occurred in pregnant women at their first trimester. The highest number of recurrent miscarriages (>4) was noted in 36-40 years of age group. Conclusion: The rate spontaneous miscarriages increases with increasing age and recurrent history of miscarriages Key words: Spontaneous miscarriage, Advanced maternal age, Recurrent


Author(s):  
Mulualem Endeshaw ◽  
Fantu Abebe ◽  
Melkamu Bedimo ◽  
Anemaw Asrat ◽  
Abebaw Gebeyehu ◽  
...  

Background <br />Preeclampsia is one of the leading causes of maternal and fetal morbidity and mortalities worldwide. Despite extensive research, the underlying cause of preeclampsia remains poorly understood. This study aimed to offer compelling evidence on the important risk factors of preeclampsia in Amhara region, Ethiopia.<br /><br />Methods<br />A case control study was conducted in public health facilities of Bahir Dar city from September 2014 to January 2015. A total of 453 (151 cases and 302 controls) pregnant women were enrolled in this study. Hemoglobin level and urinary tract infection (UTI) status were collected from clinical notes. Oral examination was performed by a dentist for detection of periodontal diseases. Univariate and multiple logistic regression analysis was conducted to determine the relationship of all the independent variables with the outcome variable. A p-value &lt;0.05 was declared statistically significant.<br /><br />Result<br />Advanced maternal age (AOR=4.79;95% CI 1.031-22.18), family history of hypertension (AOR=11.16;95% CI 5.41-41.43), history of diabetes mellitus (AOR=6.17;95% CI 2.11-20.33), UTI in the current pregnancy (AOR=6.58;95% CI 2.93-14.73), failure to comply with iron and folic acid supplement during pregnancy (AOR=8.32;95% CI 3.35-20.62), lack of exercise (AOR=3.33;95% CI 1.35-8.17), multiple pregnancy (AOR=4.05;95% CI 1.57-12.27), anemia (AOR=4.19;95% CI 1.27-13.92), and periodontal disease or gingivitis (AOR =3.51;95% CI 1.14-10.83) were associated with preeclampsia.<br /><br />Conclusion <br />Family history of hypertension was the most dominant risk factor for preeclampsia in pregnant women. Encouraging pregnant women to have health seeking behavior during pregnancy would provide a chance to diagnose preeclampsia as early as possible.


2019 ◽  
Vol 48 (2) ◽  
pp. 7-12
Author(s):  
Alpana Adhikary ◽  
Anwara Begum ◽  
Fahmida Sharmin Joty ◽  
Nihar Ranjan Sarker ◽  
Rifat Sultana

Placenta praevia is one of the most serious obstetric emergencies, which continues to be an important contributor to perinatal mortality and is responsible for leading maternal and infant morbidity. Very few data on etiology of placenta praevia are available till now. This study aims to explore the maternal risk factors related to occurrence of placenta praevia and its effects on maternal and fetal outcome. This cross-sectional observational study was carried out among 3279 obstetrics patients admitted in labour ward in the Department of Obstetrics and Gynecology, Sher-e-Bangla Medical College Hospital from January to December 2006. Out of 3279 obstetrics patients 93 placenta praevia cases were identified purposively as study subjects. The patients of placenta praevia were selected either diagnosed clinically by painless antepartum haemorrhage or asymptomatic placenta praevia diagnosed by ultrasonography irrespective of age, gestational age, parity, booking status. Pregnant woman admitted with painful antepartum haemorrhage were excluded from the study. With the ethical approval from the Institutional Ethical Committee (IEC), patients were selected after taking their written consent. A structured questionnaire and a chick list were designed with considering all the variables of interest. Out of 93 respondents, 73.88% were associated with risk factors in addition to advanced maternal age and high parity. Among them 24.73%, 33.33% and 7.52% had history of previous caesarean section (CS), MR and abortion and both CS & abortion previously. Patients aged above 30 years were 47% and 35.48% were in their 5th gravid and more; whereas, 31.18% patients were asymptomatic, 68.82% patients presented with varying degree of vaginal bleeding, among them 12.08% were in shock. Active management at presentation was done on 76.34% patients and 23.66% were managed expectantly. CS was done o 82.79% patients and only 17.2% were delivered vaginally. Case fatality rate was 1.07% and about 22% perinatal death was recorded, majority belonged to low birth weight (<1500 gm). About 10% patients required caesarean hysterectomy, 3.22% required bladder repair. Advanced maternal age, high parity, history of previous CS and abortion found to be common with the subsequent development of placenta praevia. Proper diagnosis, early referral and expectant management of patients will reduce prematurity, thereby improvised foetal outcome but to improve maternal outcome rate of primary CS have to be reduced and increase practice of contraception among women of reproductive age. Bangladesh Med J. 2019 May; 48 (2): 7-12


2017 ◽  
Vol 24 (04) ◽  
pp. 511-515
Author(s):  
Nayyab Zehra ◽  
Ahmed Hassaan Malik ◽  
Zahabia Khalid ◽  
Misha Sabir ◽  
Simra Tanvir ◽  
...  

Objectives: To determine the frequency of risk factors i.e. consanguinity andmaternal age associated with spontaneous abortions in Pakistan and to propose ways toreduce them. Study design: Cross sectional descriptive study. Place of study: Gynecologydepartment of Military Hospital and Combined Military Hospital, Rawalpindi. Duration ofstudy: 6 months (September 2015 to February 2016). Sampling technique: Non probabilityconvenient sampling. Methodology: 150 married female patients in reproductive age group(15-49 years), who were confirmed cases of pregnancy and presented with abortions, wereinterviewed and responses were filled in a structured questionnaire after written consent.The collected data was then entered and analyzed by SPSS 20.0. Results: The major bulkof spontaneous abortions occurred in the maternal age group of 25-35 years (55.3%). A totalof 53.3% of abortions occurred in the gestational age of less than 12 weeks. Around 54.7% offemales had family history of spontaneous abortions and 65.3% had consanguineous marriage.Conclusion: Spontaneous abortions occur more frequently in the females of 25-35 yearsage group and among the fetuses with gestational age less than 12 weeks (1st trimester ofpregnancy). Family history of spontaneous abortions and consanguinity are associated withspontaneous abortions.


Author(s):  
Harshita Naidu ◽  
Nivedita Hegde ◽  
Anjali M. ◽  
Rohini Kanniga ◽  
Akhila Vasudeva

Background: The majority of women who undergo induced abortion are young and of low parity. Hence, it is desirable to look for any association effects of induced abortion with future reproductive outcomes. In this study, we aim to compare ultrasound measured cervical length in pregnant women with previous induced abortion versus those who have not had an induced abortion.Methods: This was a prospective observational study performed at tertiary care hospital. Total of 400 patients were recruited, divided into two groups. Patients with an induced abortion in previous pregnancy were included as cases and those with no history were taken as controls. Cervical length was measured by transvaginal ultrasound in all participants at 11-14, 18-22 and 28-32 weeks. Pregnancies were followed up to note incidence of spontaneous preterm delivery, preterm pre labour rupture of membranes (PPROM), threatened preterm, and second trimester miscarriage.Results: Authors have found that there was no significant difference in the cervical length of pregnant patients with or without a history of prior induced abortions.  In our study authors found that mean cervical length at 11-14weeks, 18-22 weeks, and 28-32 weeks was 3.47±0.126cm and 3.48±0.195cm; 3.44±0.296cm and 3.49±0.182cm; 3.36±0.477cm and 3.42±0.310cm respectively among cases and controls. However, there was a demonstrably increased risk of spontaneous preterm delivery, PPROM and threatened preterm in patients with a history of prior induced abortion.Conclusions: Authors conclude that previous induced abortion increases the risk of threatened preterm, PPROM, spontaneous preterm delivery in the subsequent pregnancy. But, this risk is not predictable by measuring cervical length as the mean cervical length remained the same in both the groups.


2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Vanessa L. Short ◽  
Jørgen S. Jensen ◽  
Deborah B. Nelson ◽  
Pamela J. Murray ◽  
Roberta B. Ness ◽  
...  

Objective. As the consequences ofMycoplasma genitaliumin pregnant women are unknown, we examined the relationship between prenatalM. genitaliuminfection and SAB.Methods. The presence ofM. genitaliumwas determined by PCR in urine from 82 women who subsequently experienced a SAB and 134 women who maintained their pregnancies past 22 weeks gestation. The relationships betweenM. genitaliumand subsequent SAB, demographic, current pregnancy, and reproductive health history characteristics were evaluated.Results. Compared to women withoutM. genitalium, women withM. genitaliumwere more likely to report nulliparity (41.7% versus 17.4%,P=.04), history of pelvic inflammatory disease (27.3% versus 8.8%,P=.08), priorC. trachomatisinfection (63.6% versus 36.9%,P=.11,) and problems getting pregnant (18.2% versus 4.4%,P=.10).M. genitaliumwas not associated with SAB (AOR 0.9, 95% CI 0.2–3.8).Conclusions. Pregnant women who test positive forM. genitaliumdo not have an increased risk of SAB but report a history of reproductive morbidities.


2021 ◽  
Author(s):  
Giampiero Capobianco ◽  
Alessandra Gulotta ◽  
Giulio Tupponi ◽  
Francesco Dessole ◽  
Giuseppe Virdis ◽  
...  

Abstract BackgroundThe aim of the study was to evaluate maternal-foetal and neonatal clinical outcomes in a group of patients with pregestational diabetes mellitus (PGDM) such as diabetes mellitus type 1 (DM1), diabetes mellitus type 2 (DM2), and maturity onset diabetes of the young (MODY).MethodsOverall, 174 pregnant women, nulliparous and multiparous, with single pregnancy were enrolled. The selected patients were divided into two groups: PGDM (42 with DM1, 14 with DM2, and 2 with MODY); 116 patients with a negative pathological history of diabetes mellitus were the control.ResultsWe reported an incidence of preterm delivery of 55.2% in the PGDM group, of 59.5% in the DM1 group, and 42.9% in the DM2 group VS. 6% in the controls. Foetal growth disorders, such as intrauterine growth retardation, small for gestational age, and foetal macrosomia were found in 19% and 3.6% in the case and in the control group, respectively. A relationship between DM2 and gestational hypertension was found.Conclusionspatients with PGDM are at increased risk of perinatal and neonatal complications in comparison with pregnant women without PGDM.


Author(s):  
D. H. John ◽  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
N. J. Kwosah

Background: Gestational diabetes mellitus (GDM) is a common cause of hyperglycaemia in pregnancy accounting for about 90% of all diabetic pregnancies. Women with GDM are at increased risk of maternal and fetal morbidity and mortality which are preventable through early diagnosis and treatment. Objective: The aim was to determine the prevalence of GDM, compare the maternal and neonatal complications among GDM and non-GDM pregnant women, and the risk factors associated with GDM. Methodology: A prospective cohort study was carried out among 105 pregnant women attending the antenatal clinic of RSUTH between February and August 2017. They were interviewed using a pre-structured questionnaire that covered variables related to socio-demographic factors and family, medical, and social history. Fasting blood sugar (FBS) was done after an overnight fast. Women who had FBS less than 7 mmol/L had 75 g Oral Glucose Tolerant Test (OGTT) done. Those diagnosed with gestational diabetes mellitus were the exposed group while those negative for GDM were the non-exposed group. Both groups were followed up to delivery, and maternal and fetal outcomes were noted. Statistical analysis was carried out using SPSS version 20 and significance set at p < 0.05. Results: The prevalence of GDM was 10.5%. Positive history of GDM in previous pregnancy was the only independent risk factor (p=0.04, Adj OR: 26.89, 95% CI 2.86 to 252.61). GDM mothers had a significantly higher risk of developing pre-eclampsia (RR=7.48; 95% CI =3.36 to 16.63). Neonates of GDM mothers were at increased risk of fetal macrosomia (RR =9.00; 95% CI=1.36 to 59.4) and neonatal admissions (RR=8.00; C.I =1.19 to 53.67). Conclusion: The study revealed that the prevalence of GDM was high and that those with GDM were at increased risk of developing fetal and maternal complications. A history of GDM in previous pregnancy was an essential risk factor for subsequent GDM.


Author(s):  
Syed Naseer ◽  
Syed Uzma Andrabi ◽  
Syed Ishfa Andrabi ◽  
Humaira Tabasum

Background: The coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, is a global public health emergency. COVID-19 is a rapidly evolving situation, and there is limited data reporting its impact on pregnant women. Our study aimed to find the symptomatology, clinical courses and outcome of pregnant women with COVID-19 and to assess the vertical transmission potential of COVID-19 in pregnancy.Methods: This prospective observational study was conducted at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Medical College, Department of Gynaecology and obstetrics, Srinagar from May 2020 to September 2020. All COVID-19 positive pregnant patients admitted in our institution were included in our study.Results: The study included 100 Covid-19 positive pregnant women. Most of them were between 30 to 40 years of age. Median gestational age was 32.8 weeks. Comorbidity was present in 18 of our patients. 7 patients had gestational diabetes and 1 with overt diabetes, 5 were hypertensive, 3 had hypothyroidism, 1 with anti-phospholipid antibody syndrome (APLA) and 1 with asthma.44 patients were primigravidae and 56 were multigravidae. 27 patients delivered preterm and 44 with term pregnancy. 47 had undergone caesarean section and 24 normal vaginal delivery.88% of our patients were asymptomatic for covid-19 disease while as 12 patients had Covid-19 disease symptoms. The main complaints reported by patients related to covid-19 disease was mild dry cough and fever (9%). Two patients developed severe covid-19 pneumonia with ARDS and were put on ventilator, expired after 20 days of illness. All neonates were subjected to RT-PCR with none producing positive results.Conclusions: Appropriate and timely management of Covid-19 positive pregnant women is a principle for safe motherhood and healthy offspring in times of global pandemic. The present data do not suggest an increased risk of severe disease among pregnant women. We encourage the breast feeding immediately after delivery as benefits overweigh any potential risks of virus transmission if any.


2014 ◽  
Vol 18 (2 (70)) ◽  
Author(s):  
О. V. Kravchenko

We examined 42 pregnant women with twins who gave birth in 2013 in the clinical maternity hospital № 2 of Chernivtsi. It was established that multiple pregnancy is more common in multipara women of age group 25-30 years (52,3 %). The course of pregnancy with twins is aggravated in 78,5 %, which is much higher than the average population index. Dichorionic diamniotic twins dominated (57,1 %) in the structure of multiple pregnancy. The preterm labor with dichorionic diamniotic twins occur 3 times less frequently (23,6 %) than in monochorionic diamniotic multiple pregnancies (75,4 %).


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