The Course of Pregnancy and the Outcome of Childbirth in Women of Older Reproductive Age

Abstract

The purpose of the study was to determine the frequency and structure of complications of pregnancy and childbirth in pregnant women of the older age group according to the history data. Materials and methods. We examined 90 pregnant women aged 35-44 years. The groups were divided as follows: the main group (I) consisted of 30 patients, the comparison group (group II) – 30 patients and the control group (group III) – 30 patients. All patients, according to the existing standards of obstetric examination, underwent clinical and laboratory tests. Randomization was carried out according to age, social factors, concomitant gynecological and extragenital diseases. For the study, a questionnaire was developed, which, along with the social characteristics of women (age, education level, marital status), included questions about women's employment, reproductive behavior, the presence of sexually transmitted diseases, and inflammatory diseases of the female genital organs. Results and discussion. In women of older reproductive age, the course of the gestational period is reliably more often complicated by gestosis – (40.0-46.7%), the threat of termination of pregnancy (36.7-5%), premature childbirth (26.7-33.3%). In childbirth, this contingent of women is more likely to have weakness in labor (10.0-13.3%). The results of the study show that in women of the main group, pregnancies ended with spontaneous abortions significantly more often – 9 (30%), the number of operative deliveries was significantly higher – 4 (13.3%), in the comparison group there were 9 (30%) and 2 (6.7%) such women, respectively. The main complaints in previous pregnancies were pain in the lumbar region and lower abdomen – 53.3% and 46.6% among pregnant women in the main group and the comparison group. Nausea and vomiting were observed in 9 (30%) and 8 (26.6%) women, respectively, in both groups, however, in the control group, the incidence of this complaint was also quite high (16.6%). In 5 (16.6%) and 7 (23.3%) women, bloodstroke from the in vitro fertilization was revealed. In all three groups, the most common complaint was neurovegetative symptoms: sleep disturbance (8-26.6%, 10-33.3% and 4-13.3%), and appetite disturbance (10-33.3%, 6.0-20%, 9-30%). Also, 5 (16.6%) pregnant women of the main group and 6 (20%) of the comparison group complained of increased blood pressure from 8-10 weeks of pregnancy. Pregnancy in patients aged 35 years and older should be classified as pathological already in the pregravid period. Conclusion. Thus, pregnant women aged 35 and older have an extremely unfavorable background from the obstetric-gynecological history and the frequency of abdominal delivery is by 2.5-3 times higher than in the control group