Fetomaternal outcome in elderly primigravida

Abstract

Elderly primigravida is defined as women thirty five years of age or above who is pregnant for the first time. The advancement in the artificial reproductive technology have played an important part in delaying the pregnancy. Maternal age is no longer only important factor in women wishing for conception. Nevertheless the increased fetomaternal complication and consideration as a high risk leading to early intervention among these age group is of concern.The objective of the study was to find out incidence and to determine fetomaternal outcome in elderly primigravida.The study was cross sectional, conducted in Regional Institute of Medical Sciences, Imphal, Manipur over a period of one and half year. Elderly primigravida admitted at term in hospital were studied for fetomaternal outcome.Of 17890 delivery during the study period, 280 were elderly primigravida giving an incidence of 1.8%. Based on inclusion criteria, 166 were enrolled in study.Maternal compilation seen were, Oligohydraminos 6.02%, Gestational hypertension 3.01%, Breech presentation 6.03%, PROM 4.2%, Placenta Praevia 2.4%, Gestational diabetes mellitus 0.6% and Twin gestation 2.4%.Caesarean rate was 67.5% of which 62.5% was done for cephalopelvic disproportion. 5.3% baby was low birth weight.Although fetomaternal complication in Elderly Primigravida is increased, with adequate antenatal care, early recognition of complication and timely intervention, optimum outcome can be expected. Further conclusion drawn from this study is rate of Caesarean section which is of concern and needs to be further assessed.