Management of elderly primiparous women: Pregnancy and Delivery

The frequency of first pregnancies after the age of 38 is increasing steadily in Tunisia and the average age of first childbirth is now 40. Aim: To identify the profile of primiparous women over 38 years of age and the maternal, foetal and obstetric complications. Materials and Methods: We conducted a retrospective study in 2021/2022 of 50 cases in the obstetrics and gynaecology department of the Monastir maternity and neonatology centre. Results. The frequency was 0.58%, complications such as arterial hypertension, gestational diabetes, premature rupture of membranes, placenta previa and caesarean section deliveries were 6%, 34%, 14%, 2% and 84% respectively. Neonatal morbidity concerned 7 newborns, 14% of whom died in utero. Conclusion: Maternal age is a factor in complications during pregnancy and childbirth. Regular monitoring therefore ensures a fairly favourable prognosis for the outcome of these pregnancies, and monitoring must be multidisciplinary in order to intervene effectively in the event of any complications.