Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-20T00:07:44.714Z Has data issue: false hasContentIssue false

Section 6 - Obstetric Management beyond 40

Published online by Cambridge University Press:  15 September 2022

Dimitrios S. Nikolaou
Affiliation:
Chelsea and Westminster Hospital, London
David B. Seifer
Affiliation:
Yale Reproductive Medicine, New Haven, CT
Get access

Summary

Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References

Ectopic pregnancy and miscarriage: diagnosis and initial management (NG126). NICE. 2019.Google Scholar
Ectopic pregnancy and miscarriage; Quality standard (QS69). NICE. 2014.Google Scholar
Antenatal care for uncomplicated pregnancies (CG62). NICE. 2008.Google Scholar
Vitamin D: supplement use in specific population groups (PH56). NICE. 2014.Google Scholar
Hypertension in pregnancy: diagnosis and management (NG133). NICE. 2019.Google Scholar
Duley, L, Henderson-Smart, DJ, Meher, S, King, JF. Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2007, (2):CD004659.Google Scholar
Henderson, JT, Whitlock, EP, O’Connor, E, et al. Low-dose aspirin for prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2014, Vol. 160 (10):695703.Google Scholar
American College of Obstetricians and Gynecologists. Low-dose aspirin use during pregnancy. ACOG Committee Opinion No. 743. Obstet Gynecol. 2018, Vol. 132:e4452.Google Scholar
Reducing the Risk of Venous Thromboembolism during Pregnancy and the Puerperium. Green-top Guideline No. 37a. Royal College of Obstetricians and Gynaecologists. 2015.Google Scholar
Down’s syndrome, Edwards’ syndrome and Patau’s syndrome. NHS Fetal Anomaly Screening Programme Handbook. Public Health England. 2018.Google Scholar
Ashoor Al Mahri, G, Nicolaides, KH. Evolution in screening for Down syndrome. Obstet Gynecol 2019, Vol. 21:5157.Google Scholar
Twin and triplet pregnancy (NG137). NICE. 2019.Google Scholar
Gekas, J, Langlois, S, Ravitsky, V, et al. Identification of trisomy 18, trisomy 13, and Down syndrome from maternal plasma. Appl Clin Genet 2014, Vol. 7:127131.Google Scholar
Non-invasive Prenatal Testing for Chromosomal Abnormality using Maternal Plasma DNA. Scientific Impact Paper No. 15. Royal College of Obstetricians and Gynaecologists. 2014.Google Scholar
Multiple Pregnancy. StratOG. [Online] [Cited: 06 July 2020.] https://elearning.rcog.org.uk/multiple-pregnancy/epidemiology-multiple-pregnancy. Royal College of Obstetricians and Gynaecologists.Google Scholar
Dodd, JM, Dowswell, T, Crowther, CA. Reduction of the number of fetuses for women with a multiple pregnancy. Cochrane Database Syst Rev. 2015, (11):CD003932.Google Scholar
The American College of Obstetricians and Gynecologists. Multifetal Pregnancy Reduction. 2017, Committee Opinion No. 719.Google Scholar
Panagiotis, A, Papamichail, M, Theodora, M, et al. Early Pregnancy Ultrasound Assessment of Multiple Pregnancy. 2018. DOI http://doi.org/10.5772/intechopen.81498.Google Scholar
Levy, B, Sigurjonsson, S, Pettersen, B, et al. Genomic imbalance in products of conception: single-nucleotide polymorphism chromosomal microarray analysis. Obstet Gynecol. 2014, Vol. 124(2 Pt 1):202209.Google Scholar
The Investigation and Treatment of Couples with Recurrent First-trimester and Second-trimester Miscarriage. Green-top Guideline No. 17. Royal College of Obstetricians and Gynaecologists. 2011.Google Scholar
Prine, LW, MacNaughton, H. Office management of early pregnancy loss. Am Fam Physician. 2011, Vol. 84(1):7582.Google Scholar
Hooker, AB, Lemmers, M, Thurkow, AL, et al.Systematic review and meta-analysis of intrauterine adhesions after miscarriage: prevalence, risk factors and long-term reproductive outcome. Hum Reprod Update. 2014, Vol. 20(2):262278.Google Scholar
Recurrent Pregnancy Loss. Guideline. European Society of Human Reproduction and Embryology (ESHRE). 2017.Google Scholar
Coomarasamy, A, Williams, H, Truchanowicz, E, et al. PROMISE: first-trimester progesterone therapy in women with a history of unexplained recurrent miscarriages – a randomised, double-blind, placebo-controlled, international multicentre trial and economic evaluation. Health Technol Assess. 2016, Vol. 20(41):192.Google Scholar
Coomarasamy, A, Devall, AJ, Cheed, V, et al. A randomized trial of progesterone in women with bleeding in early pregnancy. N Engl J Med. 2019, Vol. 380:18151824.Google Scholar
Dhillon-Smith, R, Middleton, LJ, Sunner, KK, et al. Levothyroxine in women with thyroid peroxidase antibodies before conception. N Engl J Med. 2019, Vol. 380:13161325.Google Scholar
No authors listed. Diagnosis and management of ectopic pregnancy: Green-top Guideline No. 21. BJOG. 2016, Vol. 123:e15e55.Google Scholar
Moini, A, Hosseini, R, Jahangiri, N, et al. Risk factors for ectopic pregnancy: A case-control study. J Res Med Sci. 2014, Vol. 19(9):844849.Google Scholar
Muller, V, Makhmadalieva, M, Kogan, I, et al. Ectopic pregnancy following in vitro fertilization: meta-analysis and single-center experience during 6 years. Gynecol Endocrinol. 2016, Vol. 32:6974.Google Scholar
Talbot, K, Simpson, R, Price, N, Jackson, SR. Heterotopic pregnancy. J Obstet Gynaecol. 2011, Vol. 31(1):712.Google Scholar
Mol, F, van Mello, NM, Strandell, A, et al. Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label, multicentre, randomised controlled trial. Lancet. 2014, Vol. 383(9927), 14831489.Google Scholar
Boyraz, G, Bozdağ, G. Pregnancy of unknown location. J Turk Ger Gynecol Assoc. 2013, Vol. 14(2):104108.Google Scholar
Sagili, H, Mohamed, K. Pregnancy of unknown location: an evidence-based approach to management. Obstet Gynaecol. 2008, Vol. 10: 224230.Google Scholar
Bobdiwala, S, Al-Memar, M, Farren, J, Bourne, T. Factors to consider in pregnancy of unknown location. Women’s Health (Lond). 2017, Vol. 13: 2733.Google Scholar

References

Laopaiboon, M, Lumbiganon, P, Intarut, N, et al. Advanced maternal age and pregnancy outcomes: a multi country assessment. BJOG 2014; 121 Suppl 1:4956Google Scholar
Olusanya, B O, Solanke, OA. Perinatal correlates of delayed childbearing in a developing country. Arch Gynecol Obstet 2012;285(4):951–7Google Scholar
Dildy, GA, Jackson, GM, Fowers, GK, et al. Very advanced maternal age: pregnancy after age 45. Am J Obstet Gynecol. 1996;175(3 Pt 1):668Google Scholar
ONS. Birth Summary Tables, England and Wales, 2013. Office for National Statistics. 2014Google Scholar
Martin, JA, Hamilton, BE, Osterman, M. National Center for Health Statistics Data Brief, no. 318. Natl Cent Heal Stat 2018;318(318):415–6Google Scholar
Matthew, Ts, Hamilton, Be, First births to older women continue to rise. NCHS Data Brief 2014;(152):18Google Scholar
Royal College of Obstetricians and Gynaecologists. Reproductive Ageing (Scientific Impact Paper No. 24.2011. https://www.rcog.org.uk/guidance/browse-all-guidance/scientific-impact-papers/reproductive-ageing-scientific-impact-paper-no-24/Google Scholar
Guedes, M, Canavarro, MC. Characteristics of primiparous women of advanced age and their partners: a homogenous or heterogenous group? Birth 2014;41:4655Google Scholar
Schreinemachers, DM, Cross, PK, Hook, EB. Rates of trisomies 21, 18, 13 and other chromosome abnormalities in about 20,000 prenatal studies compared with estimated rates in live births. Hum Genet 1982;61:318Google Scholar
Gill, SK, Broussard, C, Devine, O, et al. Association between maternal age and birth defects of unknown etiology: United States, 1997–2007. Birth Defects Res A Clin Mol Teratol 2012;94(12):1010Google Scholar
Cleary-Goldman, J, Malone, FD, Vidaver, J, et al. Impact of maternal age on obstetric outcome. Obstet Gynecol 2005;105: 983–90Google Scholar
Kenny, LC, Lavender, T, McNamee, R, et al. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort. PloS One 2013;8: e56583Google Scholar
Khalil, A, Syngelaki, A, Maiz, N, et al. Maternal age and adverse pregnancy outcome: a cohort study. Ultrasound Obstet Gynecol 2013;42:634–43Google Scholar
Salihu, HM, Wilson, RE, Alio, AP, Kirby, RS. Advanced maternal age and risk of antepartum and intrapartum stillbirth. J Obstet Gynaecol Res 2008;34: 843–50Google Scholar
Giri, A, Srivastav, VR, Suwal, A, Tuladhar, AS. Advanced maternal age and obstetric outcome. Nepal Med Coll J 2012;15: 8790Google Scholar
Bahtiyar, M, Funai, E, Norwitz, E, et al. Advanced maternal age (AMA) is an independent predictor of intrauterine fetal death at term. Am J Obstet Gynecol 2006;195:S209Google Scholar
Odibo, AO, Nelson, D, Stamilio, DM, et al. Advanced maternal age is an independent risk factor for intrauterine growth restriction. Am J Perinatol 2006;23:325–8Google Scholar
Lamminpaa, R, Vehvilainen-Julkunen, K, Gissler, M, Heinonen, S. Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997–2008. BMC Pregnancy Childbirth 2012;12:47Google Scholar
Gabbe, S. Obstetrics: Normal and problem pregnancies. Philadelphia: Elsevier/Saunders; 2012Google Scholar
Page, EW, Christianson, R. The impact of mean arterial pressure in the middle trimester upon the outcome of pregnancy. Am J Obstet Gynecol 1976;125:740–6Google Scholar
Halligan, A, O’Brien, E, O’Malley, K, et al. Twenty-four-hour ambulatory blood pressure measurement in a primigravid population. J Hypertens 1993;11:869–73Google Scholar
Clapp, JF 3rd, Seaward, BL, Sleamaker, RH, Hiser, J. Maternal physiologic adaptations to early human pregnancy. Am J Obstet Gynecol 1988;159: 1456–60Google Scholar
Yılmaz, E, Tosun, ÖA, Tarhan, N, et al. Perinatal outcomes in advanced age pregnancies. J Clin Exp Investig 2016;7(2):157–62Google Scholar
El-Gilany, A-H, Hammad, S. Obstetric outcomes of teenagers and older mothers: experience from Saudi Arabia. Int J Collab Res Intern Med Public Health. 2012;4(6):901–9Google Scholar
Mehari, M-A, Maeruf, H, Robles, CC, et al. Advanced maternal age pregnancy and its adverse obstetrical and perinatal outcomes in Ayder comprehensive specialized hospital, Northern Ethiopia, 2017: a comparative cross-sectional study. BMC Pregnancy Childbirth 2020;20:60Google Scholar
Haddad, B, Sibai, BM. Chronic hypertension in pregnancy. Ann Med 1999;31:246–52Google Scholar
Rey, E, Couturier, A. The prognosis of pregnancy in women with chronic hypertension. Am J Obstet Gynecol 1994;171:410–6Google Scholar
McCowan, LM, Buist, RG, North, RA, Gamble, G. Perinatal morbidity in chronic hypertension. Br J Obstet Gynaecol 1996;103:123–9Google Scholar
Steer, PJ, Little, MP, Kold-Jensen, T, et al. Maternal blood pressure in pregnancy, birth weight, and perinatal mortality in first births: prospective study. BMJ 2004;329:1312Google Scholar
Orbach, H, Matok, I, Gorodischer, R, et al. Hypertension and antihypertensive drugs in pregnancy and perinatal outcomes. Am J Obstet Gynecol 2013;208:301 e16Google Scholar
Livingston, JC, Sibai, BM. Chronic hypertension in pregnancy. Obstet Gynecol Clin N Am 2001;28:447–64Google Scholar
Aliyu, MH, Salihu, HM, Wilson, RE, et al. The risk of intrapartum stillbirth among smokers of advanced maternal age. Arch Gynecol Obstet 2008;278:39.Google Scholar
Paulson, RJ, Boostanfar, R, Saadat, P, et al. Pregnancy in the sixth decade of life: obstetric outcomes in women of advanced reproductive age. JAMA 2002;288:2320.Google Scholar
Duley, L, Meher, S, Hunter, KE, et al. Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev 2019;10:CD004659.Google Scholar
Rashed, HEM, Maria Awaluddin, S, Ahmad, NA, et al. Advanced maternal age and adverse pregnancy outcomes in Muar, Johor. Malays Sains Malaysiana 2016;45(10):1537–42Google Scholar
Koo, Y-J, Ryu, H-M, Yang, J-H, et al. Pregnancy outcomes according to increasing maternal age. Taiwan J Obstet Gynecol 2012;51:60–5Google Scholar
Ashrafi, M, Gosili, R, Hosseini, R, et al. Risk of gestational diabetes mellitus in patients undergoing assisted reproductive techniques. Eur J Obstet Gynecol Reprod Biol 2014;176:149–52Google Scholar
National Institute for Health and Care Excellence (NICE). Diabetes in pregnancy: management from preconception to the postnatal period. NICE guideline NG3. London: NICE; 2015Google Scholar
GBD 2016 Mortality Collaborators. Global, regional, and national under‐5 mortality, adult mortality, age‐specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390:1084–150Google Scholar
Gelson, E, Gatzoulis, M, Steer, P, Johnson, M. Heart disease – why is maternal mortality increasing? BJOG 2008;116:609–11Google Scholar
Sultan, AA, West, J, Tata, LJ, et al. Risk of first venous thromboembolism in and around pregnancy: a population-based cohort study. Br J Haematol 2012;156:366–73Google Scholar
Lindqvist, P, Dahlbäck, B, MarŜál, K. Thrombotic risk during pregnancy: a population study. Obstet Gynecol 1999;94:595–9Google Scholar
Liu, S, Rouleau, J, Joseph, KS, et al. Epidemiology of pregnancy-associated venous thromboembolism: a population-based study in Canada. J Obstet Gynaecol Can 2009;31:611–20Google Scholar
Simpson, EL, Lawrenson, RA, Nightingale, AL, Farmer, RD. Venous thromboembolism in pregnancy and the puerperium: incidence and additional risk factors from a London perinatal database. BJOG 2001;108:5660Google Scholar
Royal College of Obstetricians and Gynaecologists. Reducing the Risk of Venous Thromboembolism during Pregnancy and the Puerperium Green-top Guideline No. 37a April 2015Google Scholar
Franklin, SS, Larson, MG, Khan, SA, et al. Does the relation of blood pressure to coronary heart disease risk change with aging? Circulation 2001;103:1245Google Scholar
Karami, M, Jenabi, E, Fereidooni, B. The association of placenta previa and assisted reproductive techniques: a meta-analysis. J Matern Fetal Neonatal Med 2018;31(14):1940–7Google Scholar
Amarin, V. Effect of maternal age on pregnancy outcome: a hospital based study. J Med Res 2013;1(4):2831Google Scholar
Salem Yaniv, S, Levy, A, Wiznitzer, A, et al. A significant linear association exists between advanced maternal age and adverse perinatal outcome. Arch Gynecol Obstet 2011;283:755–9Google Scholar
Wang, Y, Tanbo, T, Abyholm, T, Henriksen, T. The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations. Arch Gynecol Obstet 2011;284:31–7Google Scholar
Carolan, M, Davey, MA, Biro, MA, Kealy, M. Older maternal age and intervention in labor: a population-based study comparing older and younger first-time mothers in Victoria, Australia. Birth 2011;38:24–9Google Scholar
Hoffman, MC, Jeffers, S, Carter, J, et al. Pregnancy at or beyond age 40 years is associated with an increased risk of fetal death and other adverse outcomes. Am J Obstet Gynecol 2007;196:11–3Google Scholar
Hoque, ME. Advanced maternal age and outcomes of pregnancy: a retrospective study from South Africa. Biomed Res 2012;23(2):281–5Google Scholar
Cnattingius, S, Forman, MR, Berendes, HW, Isotalo, L. Delayed childbearing and risk of adverse perinatal outcome. A population-based study. JAMA 1992;268(7):886Google Scholar
Almeida, NK, Almeida, RM, Pedreira, CE. Adverse perinatal outcomes for advanced maternal age: a cross-sectional study of Brazilian births. J Pediatr (Rio J) 2015;91(5):493–8Google Scholar
Jacobsson, B, Ladfors, L, Milsom, I. Advanced maternal age and adverse perinatal outcome. Obstet Gynecol 2004;104:727Google Scholar
Huang, L, Sauve, R, Birkett, N, et al. Maternal age and risk of stillbirth: a systematic review. CMAJ 2008;178:165–72Google Scholar
Lean, SC, Derricott, H, Jones, RL, Heazell, AEP. Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PLoS ONE 2017;12(10):e0186287Google Scholar
Hilder, L, Costeloe, K, Thilaganathan, B. Prolonged pregnancy: evaluating gestation-specific risks of fetal and infant mortality. Br J Obstet Gynaecol 1998;105:169–73Google Scholar
Haavaldsen, C, Sarfraz, AA, Samuelsen, SO, Eskild, A. The impact of maternal age on fetal death: does length of gestation matter? Am J Obstet Gynecol 2010;203:554:18Google Scholar
Nybo Andersen, AM, Wohlfahrt, J, Christens, P, et al. Maternal age and fetal loss: population based register Linkage study. BMJ 2000;320:1708–12.Google Scholar
Flenady, V, Koopmans, L, Middleton, P, et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet 2011;377:1331–40Google Scholar
Lean, SC, Heazell, AEP, Dilworth, MR, et al. Placental dysfunction underlies increased risk of fetal growth restriction and stillbirth in advanced maternal age women. Sci Rep 2017;7(1):9677Google Scholar
Miller, DA. Is advanced maternal age an independent risk factor for uteroplacental insufficiency? Am J Obstet Gynecol 2005;192:1974–80Google Scholar
Wyatt, PR, Owolabi, T, Meier, C, Huang, T. Age-specific risk of fetal loss observed in a second trimester serum screening population. Am J Obstet Gynecol 2005;192:240–6Google Scholar
Hunt, PA, Hassold, TJ. Human female meiosis: what makes a good egg go bad? Trends Genet 2008;24:8693Google Scholar
Younis, JS, Laufer, N. Oocyte donation is an independent risk factor for pregnancy complications: the implications for women of advanced age. J Womens Health (Larchmt) 2015;24(2):127–30Google Scholar
Alio, AP, Salihu, HM, McIntosh, C, et al. The effect of paternal age on fetal birth outcomes. Am J Mens Health 2012;6:427–35Google Scholar
Reddy, UM, Ko, CW, Willinger, M. Maternal age and the risk of stillbirth throughout pregnancy in the United States. Am J Obstet Gynecol 2006;195(3):764Google Scholar
Bell, JS, Campbell, DM, Graham, WJ, et al. Do obstetric complications explain high caesarean rates among women over 30? A retrospective analysis. BMJ 2001;322:894–5Google Scholar
Wang, Y, Tanbo, T, Abyholm, T, Henriksen, T. The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations. Arch Gynecol Obstet 2011;284:31–7Google Scholar
Gilbert, WM, Nesbitt, TS, Danielsen, B. Childbearing beyond age 40: Pregnancy outcome in 24,032 cases. Obstet Gynecol 1999;93:914Google Scholar
Patel, RR, Peters, TJ, Murphy, DJ, ALSPAC Study Team. Prenatal risk factors for Caesarean section. Analyses of the ALSPAC cohort of 12 944 women in England. Int J Epidemiol 2005;34:353–67Google Scholar
Ecker, JL, Chen, KT, Cohen, AP, et al. Increased risk of cesarean delivery with advancing maternal age: Indications and associated factors in nulliparous women. Am J Obstet Gynecol 2001;185:883–7Google Scholar
Smith, GC, Cordeaux, Y, White, IR, et al. The effect of delaying childbirth on primary cesarean section rates. PLoS Med 2008;5:e144Google Scholar
Yogev, Y, Melamed, N, Bardin, R, et al. Pregnancy outcome at extremely advanced maternal age. Am J Obstet Gynecol 2010;203:558:17Google Scholar
Nove, A, Matthews, Z, Neal, S, Camacho, AV. Maternal mortality in adolescents compared with women of other ages: evidence from 144 countries. Lancet Glob Health 2014;2(3):e155Google Scholar
Nybo Andersen, AM, Wohlfahrt, J, Christens, P, et al. Maternal age and fetal loss: population based register linkage study. BMJ 2000;320:1708–12Google Scholar
Delbaere, I, Verstraelen, H, Goetgeluk, S, et al. Pregnancy outcome in primiparae of advanced maternal age. Eur J Obstet Gynecol Reprod Biol 2007;135:41–6Google Scholar
National Institute for Health and Care Excellence (NICE). Hypertension in pregnancy: diagnosis and management. NICE guideline NG133. London: NICE; 2019Google Scholar
National Institute for Health and Care Excellence (NICE). Antenatal care for uncomplicated pregnancies (CG62). London 2016Google Scholar
The Investigation and Management of the Small–for–Gestational–Age Fetus Green–top Guideline No. 31 2nd Edition | February 2013 | Minor revisions – January 2014. https://rcog.org.uk/media/t3lmjhnl/gtg_31.pdfGoogle Scholar
Reddy, UM, Ko, CW, Willinger, M. Maternal age and the risk of stillbirth throughout pregnancy in the United States. Am J Obstet Gynecol 2006;195:764–70Google Scholar
Royal College of Obstetricians and Gynaecologists. Induction of Labour at Term in Older Mothers (Scientific Impact Paper No. 34). 2013. https://www.rcog.org.uk/guidance/browse-all-guidance/scientific-impact-papers/induction-of-labour-at-term-in-older-mothers-scientific-impact-paper-no-34/Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×