“
“Objective:

To investigate the effect of age and parity on obstetric outcome in a Spanish population of pregnants aged 40 years or older delivered above 32 weeks’ gestation. Methods: A retrospective cohort of 16764 singleton pregnancies delivered above 32 weeks’ gestation between 2000 and 2007 in a nontertiary community hospital was studied. Obstetric outcomes in women aged 40 years or above (n = 335) were compared to women aged 20-29 years (n = 347) delivered at the same period. Results: During the study period, the prevalence of mothers aged 40 or above increased from 1.6% to 3%. Older pregnants were more likely to be multiparous and to have used assisted reproductive techniques. They were more likely to develop gestational diabetes (OR 7.77,

Dehydrogenase inhibitor 3.50-17.94) and preeclampsia (OR 2.60, 1.13-6.16) and to have a higher rate of cesarean delivery (OR 2.95, 1.98-4.42). Elective was the most frequent cause of cesarean delivery in this group. Newborns were at higher risk to suffer diabetes-related complications but no differences neither in 5-min Apgar score of <7 nor in the need for admission into special care baby unit were found. No perinatal deaths were registered. Conclusion: Our Spanish population of older mothers showed a higher risk for being delivered by cesarean section and NU7441 research buy for developing either preeclampsia or gestational diabetes. The overall neonatal outcome was unaffected. These data may be helpfull to counsel patients about their pregnancy expectations and possible outcomes.”
“Ovarian hyperstimulation syndrome (OHSS) is a major complication of ovulation induction. As the treatment of AICAR cell line the syndrome is Currently empirical, prevention is the most important aspect of its management. Identification of patients vulnerable to developing OHSS by taking a history of previous OHSS and polycystic ovarian syndrome is the first step in prevention. The use of mild stimulation protocols with small, closes of gonadotrophin is also important. As gonadotrophin-releasing hormone (GnRH) antagonist protocol

is associated with a lower risk of OHSS, antagonist could be the protocol of choice in high-risk patients. Withholding human chorionic gonadotrophin (HCG) and continuation of GnRH agonist will abort the syndrome but at the expense of loss of the cycle. Coasting, which involves stoppage of gonadotrophins until oestradiol drops to a low concentration before HCG injection, is in effective technique but it does not completely prevent OHSS. Intravenous albumin is useful in the prevention when given at time of oocyte retrieval. Cryopreservation of all embryos will reduce late-onset OHSS but not early-onset OHSS. In-vitro maturation of oocytes will avoid ovarian stimulation and totally prevent OHSS. Triggering ovulation with a lower dose of HCG is effective in reducing the incidence of OHSS. There are possible roles for metformin and dopamine agonist for prevention of OHSS.”
“HCV infection is a big problem worldwide.