Comparative study of Elderly Gravidae and Its Outcome with Normal Age Group Pregnancy

INTRODUCTION: Maternal and Fetal health status is directly related to wellbeing of the society. Maternal mortality rate and Infant mortality rate are important indicators of health status of society. Maternal age plays a vital role in pregnancy outcome. Both extremes of age are dangerous. Now, there is a rising trend for postponing the pregnancy for various reasons like social, economical & educational factors. This trend of delayed child bearing brings various health hazards for both mother and baby. This study is instituted with the idea of identifying the association of advanced maternal age and adverse pregnancy outcome. OBJECTIVES: • To compare demographic characteristic & obstetric risk and maternal outcome in elderly pregnancy in comparison with normal age group pregnancy • To compare perinatal outcome of elderly pregnancy with normal age group pregnancy. METHODS: This is the comparative study done in Tirunelveli Medical College. About 100 patients who came to Tirunelveli Medical College Hospital, Obstetrics and Gynaecology Department OPD and labour ward from January 2018 to January 2019 were included in the study. RESULTS: Among the women aged more than 35 years 42% conceived by artificial conception. 12% had induced abortions and 8% spontaneous abortion. overt diabetes 16%, chronic hypertension in 20%, pre-eclampsia 8%, imminent eclampsia 6%, abruption 14%, placenta previa was found in 10%, fibroid 12%, multiple pregnancy 12%, preterm delivery 38%, induction of labour, higher incidence, post operative complications, malpresentations, as far as fetal complications are concerned there is increased incidence of IUGR, NICU admissions, anomalous babies are found to higher CONCLUSION: Our study concludes that there is rised maternal morbidity and operative interventions needed with increasing age. Among the antenatal complications overt diabetes, chronic hypertension, preeclampsia, abruption, placenta praevia, uterine fibroid were found to be statistically significant. Intrapartum complications namely difficult delivery, shoulder dystocia, malpresentation, postpartum haemorrhage, PRES were found to be more among the older parturient. There is also remarkable increase in perinatal complications like babies admitted to NICU, IUGR, anomalous baby, prematurity, neonatal hypoglycemia. Prepregnancy assessment and stabilization of previous medical conditions is necessary in these patients for better outcome. Close monitoring for any complications is vital as early diagnosis and early intervention will bring an excellent maternal and fetal outcome