Pregnancy beyond 65: report of a unique case and discussion of a controversial issue.
We present the case report of a 66-year-old woman who was attended at our gynaecology department at a tertiary university hospital in Barcelona, Spain for a high-risk pregnancy and comment on the obstetric implications and bioethical issues. We retrospectively analysed clinical data about the case and bibliographic references related to the issue. The woman underwent in vitro fertilisation of donated embryos in a private centre and came to our unit at 27 weeks of gestation for pregnancy care. At 33 weeks, she presented pre-eclampsia and a caesarean section was performed. She gave birth to healthy twin boys. Four months later, she returned to our centre with the diagnosis of ovarian cancer and died 30 months after delivery. We present the clinical course and management of this pregnancy and comment on the obstetric implications, the impact on maternal and neonatal health, and bioethical issues related to assisted reproduction techniques in pregnancies beyond the natural reproductive age.
a Department of Obstetrics and Gynecology , Hospital de la Santa Creu i Sant Pau, Universitat Autonoma , Barcelona , Spain.
Marta
M
Simó González
a Department of Obstetrics and Gynecology , Hospital de la Santa Creu i Sant Pau, Universitat Autonoma , Barcelona , Spain.
Joaquim
J
Calaf Alsina
b Grifols Foundation of Bioethics, Universitat de Vic - Central de Catalunya , Barcelona , Spain.
Núria
N
Terribas Sala
a Department of Obstetrics and Gynecology , Hospital de la Santa Creu i Sant Pau, Universitat Autonoma , Barcelona , Spain.
Nerea
N
Luqui Scarcelli
b Grifols Foundation of Bioethics, Universitat de Vic - Central de Catalunya , Barcelona , Spain.
Juliana
J
Plana Borrás
a Department of Obstetrics and Gynecology , Hospital de la Santa Creu i Sant Pau, Universitat Autonoma , Barcelona , Spain.
Ana
A
Polo Ramos
D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology / Q000628:therapy; D000368:Aged; D002585:Cesarean Section; D005260:Female; D005307:Fertilization in Vitro / Q000941:ethics; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D009367:Neoplasm Staging; D018587:Oocyte Donation / Q000941:ethics; D010051:Ovarian Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D017698:Postmenopause; D011225:Pre-Eclampsia; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000503:physiopathology; D011256:Pregnancy Outcome; D011264:Pregnancy Trimesters; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects* / Q000941:ethics*; D013030:Spain; D062606:Tertiary Care Centers; D014427:Twins
Fertility; assisted reproduction; bioethical connotations; older women; pregnancy