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RCOG World Congress 2023
June 12 - 14, 2023 | London, UK
EP.1184
Retrospective review of obstetric outcomes in women over 45 years old
Poster Presenter
Authors
Affiliations
Part of Topic
High Risk Pregnancy
Retrospective review of obstetric outcomes in women over 45 years old
Julia Martyni-Orenowicz, Adam Jakes, Amanda Ali
Kingston Hospital NHS Foundation Trust, London, UK
Objective & design
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Pregnancy in women over 45 years old is associated with a greater risk of adverse outcomes including intrauterine growth restriction, gestational diabetes, hypertensive disorders and caesarean section
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We reviewed the pregnancy outcomes of all women over 45 years old who delivered at Kingston Hospital between January and December 2022
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Electronic patient records were reviewed to identify body mass index (BMI), parity, use of assisted conception (IVF), presence of preeclampsia and gestational diabetes
(GDM), use of aspirin, induction of labour (IOL), mode of delivery, gestation at delivery and estimated blood loss (EBL)
Results
Mode of delivery: 39/45 women were delivered by caesarean section; 24 elective and 15 emergency. 6/45 women achieved a spontaneous vaginal delivery; 4 of which were multiparous
Gestational diabetes: 14/45 women developed GDM including 5 women who did not undergo routine 28/40 testing and developed GDM after 32/40 weeks. 6 women required insulin therapy.
Number: 45 women over 45 years old were identified
Parity: just under half were nulliparous
BMI: the median BMI was 25 (IQR: 23-30)
IVF: 34/45 pregnancies were achieved through IVF, of which 4 were multiple pregnancies
Induction of labour: all 8 women who were induced had a caesarean section
Blood loss: median blood loss for caesarean section was 725mL (IQR: 500-1200mL)
Birth weight: median birth weight was 3325g (IQR: 2975-3590g)
Aspirin: most women were on aspirin from 12 weeks
Postpartum: one woman experienced a secondary postpartum haemorrhage and required a hysterectomy
Conclusions
•Local data suggests that women over 45 years old have a high rate of caesarean section, with a reduced success rate of IOL, particularly in nulliparous women
•These women are also more likely to have GDM and therefore the trust guideline has been amended to offer these women a routine oral glucose tolerance test at 28 weeks •We did not find a significant increase in postpartum haemorrhage or intrauterine growth restriction