Pregnancy outcome in elderly primi gravidas

Moses, Vibha; Dalal, Nilesh

doi:10.18203/2320-1770.ijrcog20163519

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…The rate of AMA in this study (25.6%) was higher than the 17% rate reported in the northern region of Saudi Arabia 13 but consistent with 23% found by a large demographic study done in Riyadh, 14 and another study in the USA. 15 Although there is a rising trend to delay childbearing secondary to improving access to education, career opportunities, contraception and assisted reproductive techniques, 8 only 6.2% of women of AMA in this study were pregnant the first time. This finding is in agreement with the finding of Fayed et al 14 They found 3.4% of their AMA population were primigravida and 70% were para five or more.…”

Section: Discussionmentioning

confidence: 66%

Comparison of pregnancy outcomes between women of advanced maternal age (≥35 years) versus younger women in a tertiary care center in Saudi Arabia

et al. 2021

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BACKGROUND: Pregnancy in women aged 35 years or above is generally considered an advanced maternal age (AMA). AMA is associated with an increased rate of maternal and neonatal complications. OBJECTIVES: Assess the effect of AMA on maternal and neonatal outcomes. DESIGN: Analytical cross-sectional study of medical records. SETTINGS: In-patient hospital tertiary care setting in Jeddah. PATIENTS AND METHODS: All women who attended antenatal care and delivered at King Abdulaziz Medical City in Jeddah in the first half of 2018 were included in the study. Outcomes for women 35 years of age or older were compared with younger women. Significant factors in a univariate analysis were entered in a multiple logistic regression model to assess the association between AMA and outcomes. MAIN OUTCOME MEASURES: Rates of maternal neonatal complications, analysis of factors associated with advanced maternal, gestational diabetes mellitus (GDM), cesarean delivery. SAMPLE SIZE: 1586 women. RESULTS: Of the 1586 women, 406 were 35 years of age or older (25.6%), and 1180 were younger than 35 years. The AMA group had a significantly higher proportion of GDM (32.0% versus 13.2%, P <.001). The adjusted odds ratio (OR) for GDM was 2.6 (95% CI 2–3.5, P <.001.) compared with younger women in the multivariate logistic regression analysis. Older women had a higher rate of cesarean delivery (43.6% versus 30.8%, P <.001). The adjusted OR for cesarean vs. vaginal delivery was 1.5 (CI 1.2–1.9, P =.002). CONCLUSION: Pregnancy in women 35 years or older was associated with an increased risk of GDM and cesarean delivery. LIMITATIONS: Cross-sectional design, small sample size, single hospital. CONFLICT OF INTEREST: None.

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Section: Discussionmentioning

confidence: 66%

Comparison of pregnancy outcomes between women of advanced maternal age (≥35 years) versus younger women in a tertiary care center in Saudi Arabia

et al. 2021

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“…[ 18 ] A study on pregnancy outcomes in elderly primigravida showed that 3% of their study population had antepartum hemorrhage, and 3% had a PPH. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

Blood component therapy in patients having massive obstetric hemorrhage in a tertiary care center in Puducherry

Anuragaa,

Chaturvedula,

Basavarajegowda

2022

Asian Journal of Transfusion Science

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INTRODUCTION: A proper transfusion protocol must be followed for every patient with massive obstetric hemorrhage (MOH), as each patient may need a different pattern of transfusion support. In this background, it is prudent to understand the current prevalent practices and devise preparatory strategies for managing blood requirements during such scenarios. This study helps us know the pattern and type of blood components given to patients with MOHs. METHODOLOGY: This prospective cross-sectional study was conducted on patients with a MOH admitted to a single center at a tertiary care teaching hospital in Puducherry between January 2020 and October 2021. During the hospital stay, patient parameters such as diagnosis, obstetric history, blood loss, transfusion of blood products, transfusion reaction, blood group, length of hospital stay, laboratory parameters, and patient vitals and comorbidities were recorded in a predesigned pro forma and tabulated into Excel sheet and analyzed using SPSS software version 19.0. RESULTS: Fifty-four patients with MOH were included in our study. The median blood loss was 2.15 L, with a range of 2 L. The mean difference between the baseline and posthemorrhage hemoglobin is 1.7 g/dl. No correlation was observed between the number of packed red blood cell (PRBC) transfused and baseline hemoglobin or between random donor platelets (RDP) transfusion and baseline platelet count. The median number of hospital stays was 10 days, ranging from 7 to 14.5 days. Eleven (20.38%) patients had a hysterectomy done to control bleeding. The remaining 43 patients were managed successfully by other measures such as medical management, compressive surgical suturing, and arterial ligation. Forty-eight (88.9%) patients survived, and 6 (11.1%) patients expired. CONCLUSION: The percentage of RDP and cryoprecipitate transfused to the patients was less than PRBC and fresh frozen plasma (FFP). The FFP-to-PRBC ratio was 2. Regular transfusion audits must be conducted to assess the flaws and improve current strategies.

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“…This increase in the average age of pregnancy affects delivery outcomes (Hwang, Kim, Yoon, & Lee, ; Jahan et al, ): older primigravidas have a higher likelihood than older multigravida of developing obstetric problems such as hypertensive illnesses, diabetes, pre‐mature birth, stillbirth, abruptio placentae and placenta previa. (Moses, & Dalal, ; Eleje, Okonkwo, Udigwe, & Eke, ; Ojule et al, ). These obstetric problems ultimately increase the frequency of induced labours or caesarean births (Fitzpatrick, Tuffnell, Kurinczuk, & Knight, ; Sauer, ).…”

Section: Introductionmentioning

confidence: 99%

Effects of a labour and delivery simulated practice programme for elderly primigravidas

2020

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Aim Increasing numbers of older gravidas compel research into best practices for their labour‐related outcomes. Responding to this need, this study sought to develop and evaluate a programme for older primigravidas. Design The authors developed a simulated practice programme for older primigravidas and tested its effects. Methods A non‐equivalent control group pre‐ and post‐test design was used with 49 community‐dwelling primigravidas. The programme taught the stages of labour using a realistic scenario‐based practice and a debriefing session. Data were collected between June and September 2015. Participants were divided into intervention (N = 25) and control (N = 24) groups. Postintervention group effects were analysed with independent t tests. Results The intervention group's levels of anxiety and stress decreased and their knowledge and self‐confidence increased. The intervention group's labour duration was also shorter than that of the control group.

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Pregnancy outcome in elderly primi gravidas

Cited by 5 publications

References 7 publications

Comparison of pregnancy outcomes between women of advanced maternal age (≥35 years) versus younger women in a tertiary care center in Saudi Arabia

Comparison of pregnancy outcomes between women of advanced maternal age (≥35 years) versus younger women in a tertiary care center in Saudi Arabia

Blood component therapy in patients having massive obstetric hemorrhage in a tertiary care center in Puducherry

Effects of a labour and delivery simulated practice programme for elderly primigravidas

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