Is the elderly primipara really at high risk?

During a five-year period, from 1970 through 1974, 26.776 deliveries occurred in our department, of which 55 (0.6%) were in elderly primiparae (EP). This group was compared with two control groups. The first comprised 97 women aged 30--34 years, and the second one, 250 women between 20 and 29 years of age. The parameters investigated were: The gynecologic past history, the course of the present pregnancy, labor, delivery and fetal outcome. In most of the cases, no significant differences were found between the EP group and the control groups. A striking difference was observed in the rate of cesarean sections, which was 49.1% in the EP group, as against only 2.3% in the age group 20--29 years. It may be concluded that by more liberal use of cesarean sections, available means of antenatal care, and prompt intervention in cases of postmaturity and prolonged labor, one can reduce the maternal and fetal morbidity and mortality, and that the EP, although a group at risk, has nowadays a better outlook for both mother and fetus.