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Background: Obstetric outcome in women with advanced maternal age (AMA) is not usually studied especially in India.Methods: This study was a case control study. The cases were pregnancy in 100 women at 40 years of age and beyond and there were two control arms of 100 each of ages 20-29 years and 30-39 years. The demography, maternal complications, delivery outcomes and neonatal outcomes were compared.Results: Women with AMA were mostly multiparous and had higher Body Mass Index (BMI). Hypertensive disease in pregnancy was more common in AMA but the difference was statistically significant. Women with AMA were more likely to have gestational diabetes (p ≤0.011), more likely to have anemia (p=0.038), more likely to have preterm birth (p=0.001), other medical complications compare to the control group (p=0.005). They were also more likely to have Lower Segment Caesarean Section (LSCS) (p ≤0.001) and have postpartum complications. The birth weight of the neonate was significantly decreased in the AMA group (p <0.001). The neonates were also more likely to be admitted to Neonatal Intensive Care Unit (NICU) (p ≤0.006).Conclusions: Adverse maternal and neonatal outcomes were seen despite individualized and optimal obstetric care. Thus, these women need preconceptional counselling.
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Objective To investigate the effect of the balloon Bionic midwifery on the delivery outcomes and to analyze the clinical value.Methods 1 683 parturients from June 2014 to May 2015 were selected.They were randomly divided into observation group (832 cases,applied balloon Bionic Midwifery) and control group 851 cases.We compared the labor,the postpartum hemorrhage,the outcomes of pregnancy and the rate of survival of neonates of the two groups.Results The first and second stage as well as the total stage of labors of the observation group were lower than the control group (P＜0.01);Also,the rate of cesarean delivery and the hemorrhage together with the asphyxia of neonates were lower than the control group (P＜0.01).However,the rate of vaginal delivery was higher than the control group (P ＜0.05).The differences between them had a great statistical significance.Conclusions The balloon bionic midwifery technology has an advantage in reducing the rate of cesarean delivery and the maternal pain of pregnant women as well as the maternal complications.It is an effective and safe midwifery technology.So it has a great value of spreading in clinical trials.
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Objective To investigate the correlation of gestational diabetes mellitus and preeclampsia and its influence on delivery outcome.Methods A retrospective analysis of 4 636 pregnant women were made,who were sin-gleton pregnancy and gestational age≥32 weeks,and the data of GDM,PE,delivery outcome were collected.Then,the incidence of PE in GDM or non-GDM were compared,the delivery outcome in pregnant women without interval med-icine comorbidity ( A group) ,GDM pregnant women( B group) ,PE pregnant women( C group) ,pregnant women com-bined GDM and PE(D group) were analyzed.Results The incidence rate of GDM was 3.71%(172/4 636) in the whole,the incidence rate of PE was 5.65% (262/4 636).The incidence rates of PE among GDM and non-GDM pregnant women were 11.63%(20/172) and 5.42%(242/4 464),the difference was statistically significant(χ2 =5.983,P<0.05).The average pre-pregnant body mass index(BMI),Apgal scores at 1 minute and 5 minutes were compared,and the differences among the four groups were statistically significant( F=29.142,16.074,35.415,all P<0.01),and those in C group,D group were significantly lower than in group A and group B [t(C-A) =5.386, 4.821,5.224,t(C-B) =5.023,4.456,6.278,t(D-A) =6.753,5.012,6.443,t(D-B) =6.475,4.727,7.622,all P<0.01].The rates of neonate intensive care,giant baby natality,small-for-gestational-age children,premature labor were compared,and the differences among the four groups were statistically significant (χ2 =157.290, 96.129, 46.969,27.005,all P<0.1),the rates of neonate intensive care in C group and D group were higher than in A group and B group[χ2(C-A) =47.294,χ2(C-B) =15.547,χ2(D-A) =17.280,χ2(D-B) =7.088,all P<0.01],the rates of giant baby natality in B group were higher than A group,C group [χ2(B-A) =29.445,χ2(B-C) =6.597,all P<0.05],the rates of small-for-gestational-age children and premature labor in D group were higher than A group,B group and C group[χ2(D-A) =42.676,26.261,χ2(D-B) =9.070,10.879,χ2(D-C) =25.117,8.653,all P<0.01].Conclusion Pregnant women with GDM might have higher risk of suffering PE than those non-GDM gravidas,the PE,GDM com-bined with PE seriously influence perinatal outcome,pregnancy care should be strengthened to prevent and treat.