Background: Elderly primigravida is defined as all women going through their first pregnancy over the age of ≥35 years. They are considered to be categorized as high-risk pregnancy. Advanced contraception methods and artificial reproductive technology have played key role in delaying the pregnancy. Methods: A retrospective study of fetomaternal outcome in elderly primigravida was conducted at department of obstetrics and gynecology, GMERS medical college, Junagadh from 1st September 2021 to 1st August 2022. All the patient data was obtained from their case records and indoor files and were followed up till delivery for fetal outcome. Results: There were 54 elderly primigravida patients in our study with an incidence of 1.05% based on the inclusion criteria with 96.3% between the age 35-40 years. Most common reason for delayed child bearing was pursuing higher education and work preferences. Gestational hypertension was most common maternal complication (48%), associated with preeclampsia in 28%. Among fetal complications 46% had low birth weight, 38.5% had IUGR. 54% patients had delivered by LSCS. Conclusions: Although elderly primigravida is considered a high-risk pregnancy with increased maternal and fetal complications, proper antenatal care, early recognition of maternal risk factors with timely intervention pregnancy outcome can be improved.

Background: Hypertensive disorder of pregnancy is one of the most common complications that affect the human pregnancy. Hence it is important to identify women at risk of developing gestational hypertension or preeclampsia, its early diagnosis and subsequent consequences due to uteroplacental insufficiency with help of Doppler ultrasound, to improve perinatal outcome. The objective of this study was to study the application of Doppler ultrasound with analysis of blood flow velocity waveform in gestational hypertension and to examine and study the perinatal outcome in pregnancy with altered Doppler indices.Methods: A prospective study was carried out in 50 antenatal patients diagnosed to have gestational hypertension during a period of 12 months to evaluate the role of color Doppler imaging in gestational hypertension in patients more than 28 weeks of gestation, the initial scan was performed immediately after the diagnosis. This study analyzed the blood flow in umbilical artery, maternal uterine artery and fetal middle cerebral artery using Doppler ultrasound.Results: In this study approximately 76% of cases were found in 20-30 years group. 58% showed abnormal umbilical artery Doppler while 42% women had normal umbilical artery Doppler. In this study 23 cases had cerebro-placental index <1 and 27 cases had cerebro-placental index >1. Cases with cerebro-placental index <1 had various complications like preterm delivery, low birth weight, increased chances of still birth, intra uterine death (IUD), increased NICU admission. In this study 31 cases had abnormal uterine artery Doppler which accounts for 62% of total cases, while 38% had normal uterine artery Doppler.Conclusions: Doppler ultrasound can reliably predict any adverse fetal outcome in hypertensive pregnancies and can be a useful tool for decision making in appropriate timing of intervention for delivery.