Background: Advanced maternal age generally signifies age after 35years during the time of delivery. Although the fact that being pregnant at any reproductive age is not risk-free, older gravidity usually caps with adverse outcomes both to the mother and fetus or neonate. Objective: The key objective of this study was to compare pregnancy outcomes associated with three different maternal age groups. Materials and Method: It was a comparative observational study performed at the Department of Obstetrics and Gynecology, Shaheed Suhrawardy Medical College & Hospital, Dhaka, Bangladesh. The study included all women who delivered in gyane & Obs department at 24 weeks’ gestation period from January 2017 to December 2018. Results: In this study, three maternal groups were considered as the younger age group of 18-29 years, middle age group of 30-34 years, and advanced mother age (AMA) 35-40 years in maternal age. Chronic hypertension was significantly associated with maternal age. However, antepartum hemorrhage, placenta previa, abruptio placenta, gestational hypertension, preeclampsia, eclampsia, gestational diabetes mellitus (GDM), and bad obstetrics history (BOH), were not statistically significant (p>0.05). Regarding malpresentation, breach, transverse lie, congenital malformation, intrauterine device (IUD), preterm labour, prolonged labour, obstructed labour and postpartum hemorrhage (PPH) were not statistically significant (p>0.05). Low birth weight was found 38(30.9%) in the age group 18-29 years, 9(20%) of 30-34 years, and 3(18.8%) in the age group 35-40 years. Intrauterine growth restriction (IUGR) was found 3(2.4%), stillbirth 6(4.9%), prematurity 4(3.3%) and macrosoma 1(0.8%) in the age group 18-29 years, in the age group 35-40 years, NICU admission was needed 36(29.3%) in the age group of 18-29 years,8(19.5%) in age group30-34 years and 2(12.5%) in the age group 35-40 years. The difference was not statistically significant (p>0.05). Conclusion: In our findings demonstrate that though any reproductive age groups are not risk-free of pregnant women, over 35 years are at elevated risk for rising complications and should, therefore, be managed with proper care protocols, particularly in cases of maternal complications of pregnancy.

Uterine rupture on healthy uterus is a very rare obstetric complication; few cases have been described in the literature. We report a case of rupture taken care of in our training. Multiparity and cross-presentation were the main risk factors. The treatment was conservative with a tubal section tightening to avoid the risk of recurrence.

Background: Maternal genital tract colonization with GBS during pregnancy is an important risk factor for neonatal GBS infections. Methodology: This prospective study was done to determine Group B streptococcus (GBS) colonization in pregnancy using selective and non-selective culture media. The total sample size was 300 pregnant women. In 200 women, vaginal and rectal swabs were collected and inoculated separately in non- selective blood agar media and in another 100 women, vaginal and rectal swabs were collected and inoculated separately in selective Todd-Hewitt broth media for GBS isolation. Results: The detection rate for GBS was more when Todd Hewitt Broth was used for initial inoculation than direct inoculation in blood agar. The overall GBS prevalence rate among pregnant women was 2.3% in our study. Conclusion: Our finding supports the current recommendations that inoculation in selective medium is fundamental to maximize GBS detection rates and should be employed by laboratories involved in screening of pregnantwomen.

The objective of this clinical case report is to highlight an uncommon presentation of chorioamnionitis as status epilepticus, complicated by consumptive coagulopathy and recurrent hypoglycemia. A primigravida of 18 weeks gestation, presented to the Accident and emergency department via ambulance with seizures. She did not have any hand-held medical records. No history could be obtained as she is a visitor with no friends and family. She was disoriented with Glasgow coma scale of 10/15, random blood sugar of 1.8, blood pressure 88/58, pulse 130, and temperature 36.8°C. Scan showed an 18 weeks live fetus. She was having uncontrollable seizures even after her glucose was corrected. Patient was also started on magnesium sulphate and anti epileptic infusions. She was intubated and transferred to ICU. On vaginal examination smelly discharge was noticed. Patient was started on Broad spectrum antibiotics. Her WCC elevated to 23, other investigations like Liver function tests, urea & electrolytes and creatinine were normal. The next day patient aborted spontaneously and continued to be tachycardic, tachypneic and hyperthermic with labs showing a picture of consumptive coagulopathy. Urine, blood culture and CSF cultures were normal. After Inotropes, antiepileptic’s, platelet transfusion, broad spectrum antibiotics, and appropriate fluid management, patient’s condition improved. Placental histopathology confirmed chorioamnionitis. She required ventilator support for 13 days. She suffered with recurrent episodes of hypoglycemia even after her sepsis was resolved which was treated by dextrose infusion and steroids and resolved spontaneously. She was discharged on 44th day of her hospital stay in stable condition.