Obstetrical Management of the Older Gravida

Maximilian B Franz; Peter W Husslein

Disclosures

Women's Health. 2010;6(3):463-468. 

In This Article

Future Perspective

Obstetric management of gravidas of advanced age will become more and more important. Owing to social development and reproductive medicine in the future, even more women will delay childbearing and become older mothers.

Advanced maternal age is associated with increasing risks during pregnancy and delivery. The increasing cesarean delivery rates in older gravidas are only partially caused by increasing gestational complications. Nevertheless, cesarean delivery rates will probably show a steady increase in the future, especially in mothers of advanced age.

With increasing numbers of women delaying childbearing, in many cases, pregnancy and delivery will become a single event in a mother's life, and therefore, will be of more importance to the families. Therefore, not only the quality of medical treatment but also the quality of support and service during pregnancy and delivery will become essential and might be a reason for increasing cesarean delivery rates. Where affordable, hotel-like delivery clinics with high medical standards for 'the one birth' of wealthy patients might become a concept for the future.

Between 10 and 15 years ago, women over 35 years of age were treated as being at high risk for pregnancies and gravidas aged over 40 were rare cases. In the future, the gravida aged over 40 years will probably become as common as the gravida aged over 35 years currently is. With modern obstetric management, most of the occurring complications can be managed successfuly. However, more counseling of younger women before delaying childbearing regarding their later risks of lower fertility and the higher pregnancy complication rates is needed.

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