Magistrado Leila, Tolcher Mary C, Suhag Anju, Zambare Sonal, Aagaard Kjersti M
Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX, USA.
Department of Anesthesiology, Division of Obstetric Anesthesia, Baylor College of Medicine, Houston, TX, USA.
Case Rep Obstet Gynecol. 2020 Sep 12;2020:9801565. doi: 10.1155/2020/9801565. eCollection 2020.
There is limited data on the anticipated perinatal course among gravidae in their sixth and seventh decades. Our objective was to describe the relatively uncomplicated prenatal, intrapartum, and postpartum course of a 67-year-old essential primigravida. Briefly, our patient conceived a singleton pregnancy via IVF with donor oocytes, then presented at 13 6/7 weeks of gestation to initiate prenatal care. Her medical history was significant for chronic hypertension, hyperlipidemia, and obesity. Her cardiac function was monitored throughout pregnancy, and she delivered at 36 1/7 weeks by cesarean for a decline in left ventricular function with mitral regurgitation. Her intrapartum and postpartum course was uncomplicated, and she was able to successfully breastfeed for six months and resume prepregnancy activity. For comparison, we analyzed deliveries among gravidae > 45 years of age from our institutional obstetrical database (2011-2018). This case represents the eldest gravidae identified in the literature and illustrates the potential for a relatively uncomplicated perinatal course with successful lactation. This case may enable other providers to counsel elderly patients on anticipated outcomes inclusive of ability to breastfeed.
关于六七十岁孕妇围产期预期过程的数据有限。我们的目的是描述一位67岁初产妇相对简单的产前、产时和产后过程。简而言之，我们的患者通过体外受精和供体卵母细胞受孕，单胎妊娠，然后在妊娠13 6/7周时前来开始产前护理。她有慢性高血压、高脂血症和肥胖的病史。整个孕期都对她的心脏功能进行了监测，由于左心室功能下降伴二尖瓣反流，她在36 1/7周时剖宫产分娩。她的产时和产后过程均无并发症，并且能够成功母乳喂养六个月并恢复孕前活动。为作比较，我们分析了我院产科数据库（2011 - 2018年）中45岁以上孕妇的分娩情况。该病例是文献中报道的年龄最大的孕妇，说明了围产期过程相对简单且能成功哺乳的可能性。该病例或许能让其他医疗人员就包括母乳喂养能力在内的预期结果为老年患者提供咨询。
