초산부에서 연령에 따른 분만 및 분만방법의 추세 ( 1985~1995 년 ) = The Trends of Delivery Outcomes and Mode by Age Factor in Primiparous Women ( 1985~1995 years )

다국어 초록 (Multilingual Abstract)

With the changing life style of women in current society, there is often postponement of childbearing and the pregnancy rate of teenage and elderly mothers is increasing. Thus the impact of maternal age on delivery outcome and mode becomes important. This study was carried out retrospectively based on the clinical charts of 18,160 primiparous women who had delivered from January, 1985 to December, 1995 at the department of Obstetrics & Gynecology, Sung Ae Hospital. The results obtained were as follows; 1. Total primiparous deliveries were 18,160 cases and the overall incidence of cesarean section was 43.3%. 2. The mean age of total 18,160 delivered primiparous women was 26.4 years. 3. In 1985, the rate of primiparous delivery was 0.5% under 19 years and 0.9% over 35 years, this rate rose to 1.5% under 19 years and 2.0% over 35 years in 1995. The rate was 1.9 times as high in 1995 as in 1985 for mothers age 35 over and 2 times as high for teenage mother. 4. 17,107 cases(94.2%) were vertex presentation, 1053 cases(5.8%) were breech presentation. 5. 10,295 cases(56.7%) delivered vaginally and 7,865 cases(43.3%) abdominally. 6. In the types of operation, lower segmental transverse incision was the most common (99.5%), and classical section was 0.2% in rate. 7. According to maternal age distribution, cesarean section rate was 24.1% in under 19 years group, 38.1% in 20~24 years group, 42.8% in 25~29 years group, 54.7% in 30~34 years group, 76.4% in over 35 years group. 8. The indication for primary cesarean section were cephalopelvic disproportion(59.5%), breech(13.1%), failure to progress in labor(9.0%), fetal distress(6.5%), placenta previa(2.9%), twin(2.2%), placenta abruption(0.4%). 9. Maternal age was a strong determinant of delivery mode in this study ; the Cesarean rate in women aged>35 years was about three times the rate reported in teenagers. In conclusion, delivery outcomes and mode markedly changed for recent 11 years. That changes was increment of teenage mothers and elderly mothers. There was also an increased frequency of cesarean section rate in the older women. Thus maternal age factor is important for delivery outcomes and mode in primiparous women. So careful antenatal and intrapartal care should be performed for the older aged pregnant women and teenage mothers.