Ragosch V, Altinöz H, Hundertmark H, Entezami M
Universitätsfrauenklinik, Klinikum Benjamin Franklin, FU Berlin.
Z Geburtshilfe Neonatol. 1997 May-Jun;201(3):86-90.
In order to determine the birth risk for pregnant women in the age group > or = 40, the delivery data of 143 pregnant women in this age group were retrospectively evaluated over a 3-year period. Here, 37 of these 143 women (25.9%) were primiparae. The following was examined: The number of prenatal examinations (including ultrasound examinations), the incidence of genetic examinations, the delivery methods with the percentage of surgical deliveries, complications at the time of delivery as well as the fetal outcome with APGAR values, umbilical artery pH, birth weights, neonatal morbidity and mortality. The delivery results were compared with representative populations of women between 20-29 years (n = 2252) and 30-39 years (n = 1980). Pregnancy in older women still ends significantly more often with cesarean section than in younger women. Here, the rate of cesarean sections was 32.7% compared to 21.9% in 30-39-year-olds and 15.8% in 20-29-year-olds. However, parity has an even greater influence on the mode of delivery than age. Only 30.1% of multi-parae over 40 years underwent surgical delivery (vaginal and abdominal) compared to 77.3% of primiparae. It was also found that multiparae more rarely had surgical delivery than younger primiparae (30-39 years 53.3%, 20-29 years 39.3%). Despite the high surgical delivery rate being in the group of primiparae over 40 years, the fetal outcome was comparatively poor, so that the less restrictive indication for surgical delivery seems justified.
为了确定年龄≥40岁的孕妇的分娩风险，对该年龄组143名孕妇在3年期间的分娩数据进行了回顾性评估。在这143名妇女中，有37名（25.9%）为初产妇。研究了以下内容：产前检查次数（包括超声检查）、基因检查发生率、手术分娩百分比的分娩方式、分娩时的并发症以及胎儿结局（包括阿氏评分、脐动脉pH值、出生体重、新生儿发病率和死亡率）。将分娩结果与20 - 29岁（n = 2252）和30 - 39岁（n = 1980）的代表性女性群体进行了比较。与年轻女性相比，高龄女性的剖宫产分娩结束的情况仍然明显更多。其中，剖宫产率为32.7%，而30 - 39岁女性为21.9%，20 - 29岁女性为15.8%。然而，胎次对分娩方式的影响比年龄更大。40岁以上经产妇中只有30.1%接受了手术分娩（阴道分娩和剖宫产），而初产妇为77.3%。还发现经产妇比年轻初产妇（30 - 39岁为53.3%，20 - 29岁为39.3%）更少进行手术分娩。尽管40岁以上初产妇组的手术分娩率较高，但胎儿结局相对较差，因此手术分娩的指征放宽似乎是合理的。
