Childbearing at very advanced maternal age, the challenges and complications: A report of two cases

Abstract

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. The desire for childbearing at very advanced maternal age (maternal age ≥45 years at the time of delivery) is becoming increasingly common. This has resulted in increased demand and utilization of assisted reproductive technologies to counteract the declining fecundity associated with the advanced maternal age. However, the older gravidas are at increased risk of having various medical conditions with potential adverse impact on their pregnancies making such pregnancies be considered as high risk pregnancies. Case Report: We present two cases of very advanced maternal age pregnancies (54-year-old and 49-year-old), both conceived through assisted reproductive technology, we successfully managed through their pregnancies outlining the conception challenges, pregnancy complications and the subsequent management and outcomes. We further undertake a literature review to assess the challenges and outcomes of pregnancies at very advanced maternal age. Conclusion: Childbearing at very advanced maternal age is challenging from conception to delivery. Owing to the age related decline in fertility, most of these women require assisted reproductive technology (ART). Moreover, they are more likely to have adverse pregnancy outcomes principally stemming from preterm births with a resultant greater maternal and perinatal mortality and morbidity. With the increasing trend towards delayed child bearing, and owing to the anticipated adverse pregnancy outcomes, the hospitals and physicians needs to equip themselves for the increased demand for ART and the need for sophisticated prenatal, perinatal and postpartum care. IJCRI publishes

Prevalence of and factors associated with female sexual dysfunction among women using hormonal and non-hormonal contraception at the AGA Khan University Hospital Nairobi

“…Using the 2017 study by Oindi et al (an unpublished study conducted at AKUHN), the prevalence they obtained from their study was used for calculating sample size, where P 1 was the prevalence of sexual dysfunction in the group of women in the study who were using non-hormonal contraception. We aimed to detect at least a 10% difference ( P 1 = 26.9%) 5 in proportion with FSD in this group. A 10% difference in prevalence of FSD between the two groups was thought to be clinically significant.…”