An interpretation for Chinese expert consensus on how to manage pregnant women of advanced maternal age with scarred uterus

Abstract

Deferral of marriage and child-bearing age as well as high occurrence of uterine surgery history such as cesarean section and myomectomy in women who are about to have babies are challenging obstetrical health care worldwide, since pregnancy at advanced maternal age and pregnancy with scarred uterus are both high-risk pregnancy. In China, one-child policy had been implemented for three decades and contributes to high cesarean section rates. With family planning policy turning to two and three-child, there are rising pregnancy at advanced maternal age with scarred uterus. A clinical management scheme can help obstetricians a lot to assess risks, prevent pregnancy complications and manage pregnancy in an organized manner. However, there are insufficient studies on relevant clinical issues for the specific population, and there is no consensus or practice guidelines until now. We have developed Chinese expert consensus based on our pioneering research findings on the prevention and treatment strategy for major pregnancy complications in women of advanced maternal age. We formulate the consensus comprising general management scheme to standardize clinical care, practical risk scoring systems to early warn major pregnancy complications, and nationwide expert recommendations to be in accordance with evidence-based appraisal method. Consecutive supervision along with stratified management are highly emphasized. We interpret the consensus containing up-to-date literature review, research findings interpretation and most concerned questions discussion. This consensus interpretation helps standardize how to manage pregnant women of advanced maternal age with scarred uterus and improve the maternal-fetal outcomes.