Effects of modes of delivery on pregnancy outcomes of primiparas of advanced maternal age after 37 weeks
JIANG Haili1,REN Mingbao1,LU Chang1,and MA Huashu2
1.Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University,Beijing100026,China; 2. Department of Obstetrics, Xingtai People’s Hospital Affiliated to Hebei Medical University, Xingtai 054000, China
Abstract：Objective To explore the cesarean section rate and the clinical features of trial of vaginal delivery in primiparas of advanced maternal age after 37 weeks. Methods A retrospective study was conducted of the primiparas of advanced maternal age after 37 weeks of pregnancy in Beijing Obstetrics and Gynecology Hospital between January and July 2018. Data on the age, gravidity, history of adverse pregnancy, pregnancy complications, gestational weeks, mode of delivery, fetal distress, neonatal asphyxia of these primiparas was collected for statistical analysis. Results Among the 746 cases of delivery, 303 cases (40.62%)chose cesarean section and 443 cases (59.38%)requested trial of vaginal delivery, 75 of whom (16.93%)were transferred to cesarean section, 368(83.07%)had successful vaginal delivery and 38 cases (10.32%)delivered by forceps. In the group aged 35 to 37 and the group above 38 years old, the rate of transferred cesarean section was 17.24% and 15.15%, respectively, (P=0.870) and the rate of forceps delivery was 7.43% and 15.15%, respectively (P=0.021). The rates of neonatal asphyxia in the groups of elective cesarean section, transferred cesarean section and normal vaginal delivery were 5.30%,40.00% and 21.47%, respectively(P=0.000). Conclusions The chances of transferred cesarean section are not increased in the group above 38 years old. The rate of fetal distress in the transferred cesarean section group increases, but the rate of neonatal asphyxia does not. After adequate assessment, most of the primiparas of advanced maternal age after 37 weeks of pregnancy can have successful vaginal delivery.
姜海利, 任明保, 路畅, 马华姝. 妊娠足月高龄初产妇的分娩方式及对妊娠结局的影响[J]. 武警医学, 2019, 30(1): 35-37.
JIANG Haili,REN Mingbao,LU Chang,and MA Huashu. Effects of modes of delivery on pregnancy outcomes of primiparas of advanced maternal age after 37 weeks. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(1): 35-37.
Chen C P, Chern S R, Tsai F J, et al. Down syndrome due to unbalanced homologous acrocentric rearrangements and its recurrence in subsequent pregnancies:prental diagnosis by amniocentesis [J].Taiwan J Obstet Gynecol, 2009, 48(4): 403-407.
Renz-Polster H,David M R,Buist A S,et al.Cesarean section delivery and the risk of allergic disorders in childhood[J]. Clin Exp Allergy, 2005, 35:1466-1472.
[11]
Roduit C,Scholtens S, de Jongste J C. Asthma at 8 years of age in children born by caesarean section,Thorax,2009,64:107-113.
[12]
Tita A T N, Landon M B, Spong C Y,et al.Timing of elective repeat cesarean delivery at term and neonatal outcomes[J].N Engl J Med,2009,360(15):1570-1571.
2019, Vol. 30 
