Few women venture back into pregnancy if, as was the case with the Countess of Wessex, their previous one was so near to disaster.

Although it is becoming more common for women to have children later in life, the trend has its dangers. If the general medical assumption is correct and the Countess’s serious haemorrhage was the result of premature separation of the placenta from the wall of the uterus, known as placenta praevia, age may well be a factor. Her first pregnancy was ectopic, and required urgent surgery. In some cases the placenta may subsequently become lodged near the junction of the uterus and the remaining Fallopian tube. This can lead to haemorrhage.

After the age of 35 there is increased likelihood of the mother developing high blood pressure in pregnancy, placental abruption, diabetes and placenta praevia. The haemorrhages that result from premature separation of the placenta from the wall of the uterus may either be obvious, because the blood has leaked or poured out, or may be concealed behind the placenta. In either event the placenta’s efficiency is reduced and the baby suffers.

If the haemorrhage is gross and follows extensive separation of the placenta from the uterus wall, the mother suffers shock and collapse. Placental abruption occurs in 5 per cent of pregnancies, but in only 1 per cent does it prove fatal. The prospects for the baby are worse.

Women who become pregnant over the age of 35 should take lots of rest, avoid long flights and car journeys and have regular screening.

A careful check is kept on the blood pressure of older mothers and on their blood glucose levels. It is no longer considered adequate to use only urine tests to detect any tendency they may be showing of diabetes.

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