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KMID : 0378019720150080039
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New Medical Journal
1972 Volume.15 No. 8 p.39 ~ p.44
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A Clinical and Statistical Study of the Elderly Primiparas
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洪性善/Hong, S.S.
宋燦浩/郭顯模/Song, C.H./Kwak, H.M
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Abstract
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It is well known that the elderly primipara differs from the younger primipara in such things as a higher incidence of antepartal complications, of prolonged labor, of prematurity, of Cesarean section, of perinatal mortality and of maternal mortality. Reviews of the elderly primipara in Korea are lacking and it was felt that such a review would be of interest.
The cases are taken from the files of the Dept. of Obst. and Gyne., Severance Hospital and include all patients delivered from Febuary, 1959 to August, 1967. Also the records of the Cheil Hospital from January, 1964 to August, 1967 were reviewed. There were 46 cases from Severance Hospital and 29 cases from the the Cheil Hospital.
Our definition of an elderly primipara was any woman pregnant for the first time after the age of 35 with a fetus of over 1, 000 gms.
The results obtained are as followings
1. There were 75 cases among a total of 7367 deliveries, an incidence of 1.01%.
2. Maternal age was distributed from 35 to 46 year. The majority (50.7%) were in the age groups of 35 and 36 year. The oldest patient was 46 years old.
3. The 75 cases were almost equally distributed over the 7 year span.
4. Concerning the antepartal complications, the incidence of acute toxemia was 18. 7% that is higher comparing with 9. 0% in the younger primiparas. The spontaneous premature rupture of membrane was seen in 22.8% of the cases; higher than 8. 1% in the control group.
5. 67 cases (89. 30) were of vertex presentation and breech presentations were 8 cases (10.7%). The incidence of breech presentation was higher than that of breech presentation is total deliveries from Severance Hospital (5. 1%).
6. 51 cases (68%) delivered vaginally and 24 cases (32%) abdominally.
7. Among the indications for Cesarean section the highest was C. P. D. (50%). Other indications were elderly primipara, fetal distress, uterine desfunction, breech presentation, cervical myoma and status post-Shirodkar operation in order of frequency.
8. The perinatal mortality was 26.7 (Stillbirth and neonatal death one each) 9. No. congenital malformation of infants was noted. 10. The incidence of spontaneous abortion was 18.7%.
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