Problems faced by people who are old enough to have children again – a significant increase in pathological pregnancies (1) Gestational diabetes Mothers of advanced age are prone to diabetes. With age, the body’s glucose tolerance decreases, and obesity are all risk factors for diabetes. Diabetes has a great impact on the fetus, including: (1) an increase in the rate of preterm delivery, mainly due to excessive amniotic fluid, medical factors need to terminate the pregnancy in advance; (2) the incidence of macrosomia increased, the rate of obstructed labor and cesarean section rate increased; (3) an increase in the chance of fetal death in utero, mainly due to the pregnant woman’s hyperglycemia, reducing the placental supply of blood and oxygen to the fetus, resulting in intrauterine hypoxia, and in severe cases of intrauterine foetal death; (4) fetal malformation rate increased significantly; (5) neonatal mortality increased; (6) neonatal respiratory distress syndrome, neonatal hypoglycemia, etc.. It is important to recognize the seriousness of diabetes mellitus in pregnant women of advanced age, the need to do a good job of pre-pregnancy publicity and post-pregnancy gestational diabetes standardized screening and detection, regular monitoring of blood glucose to ensure that their blood glucose is in the normal range, in the case of unsatisfactory dietary control, exercise interventions for blood glucose, the timely use of insulin for treatment, if the timely diagnosis and treatment can reduce the occurrence of complications in mothers and infants, for the lowering of the morbidity and mortality of perinatal infants, It is of great significance to reduce the perinatal mortality rate, the incidence of macrosomia and the prevalence of neonatal disease. (2) Hypertensive disorders in pregnancy The incidence of hypertensive disorders in pregnancy is higher among pregnant women of advanced age than among young pregnant women. The reasons for this are: pressure from the family and the outside world, which makes them mentally nervous; previous bad deliveries, the incidence of hypertensive disorders during pregnancy is higher in the current pregnancy. Many pregnant women of advanced age have pre-existing medical diseases, such as primary hypertension and metabolic diseases. Pregnant women over 35 years of age are prone to complications of hypertensive disorders of pregnancy in the second trimester, especially severe preeclampsia. Fetal loss in the first pregnancy, high fertility expectations, and genetic heterogeneity predispose to recurrence of early preeclampsia in the second pregnancy, thus leading to the risk of further fetal loss. Prevention focuses on rational nutritional management, eating foods rich in protein, vitamins, iron, calcium, magnesium, selenium, zinc and other trace elements and fresh fruits, high fiber, vegetables, whole grains and brown bread, and reducing the intake of animal fats has been associated with a lower risk of preeclampsia. Calcium supplementation of 1 g/d during pregnancy is associated with a 50% reduction in the risk of developing preeclampsia, with the benefits being most pronounced in high-risk individuals. Low-dose aspirin 50-100mg per day can prevent preeclampsia in high-risk pregnant women. (3) Scarred uterus The birth of a second child in a woman with a scarred uterus is more complicated and dangerous than in a person with an intact uterus, and is a centralized issue that the majority of women with scarred uterus who have a request to have another child and their families wish to understand and consult. Women with a history of cesarean section have a significantly increased risk of keloid pregnancy, aggressive placenta praevia, uterine rupture, postpartum hemorrhage, and hysterectomy during labor, as well as surgical injury and preterm birth when they become pregnant again. Therefore, preconception counseling and health care for women with keloid uterus should provide proper advice on the timing of a second pregnancy, health care and precautions to be taken during pregnancy, and the timing and mode of delivery, and the risks associated with a second pregnancy with keloid uterus should be adequately communicated to improve the outcome of the mother and child. The physician must be aware of the factors affecting the healing of the uterine incision during the history taking, mainly: nutritional status? Previous surgery? Infection, surgical procedure? Sutures? How much time has elapsed? Once the scarred uterus reaches late pregnancy, it is also important to know about the scar site. If the ultrasound observation is that the wall of the lower uterine segment is <3mm< span=""> thick, the thickness of the lower segment is uneven, loss of continuity, and the amniotic sac flows toward the lower uterine segment defect, then it is important to pay close attention to it. (4) Placenta praevia A second pregnancy after cesarean section requires vigilance for aggressive placenta praevia. Aggressive placenta previa is defined as placenta previa that occurs in a second pregnancy after cesarean section if the previous pregnancy was a cesarean section and this time there is placenta previa. After cesarean section, the endometrium is damaged, and placenta praevia and placenta implantation are formed at the incision, often implantation placenta or even penetrating placenta, which often leads to unforeseen hemorrhage, resulting in diffuse intravascular coagulation, hysterectomy and other complications. For second pregnancies, we should be highly vigilant for placenta implantation, mainly based on the combination of preoperative ultrasound and/or magnetic resonance examination, intraoperative clinical diagnosis and postoperative pathologic diagnosis. Clinical diagnosis is mainly based on the intraoperative finding that the placenta cannot be detached on its own, or that some or all of the placenta is attached to the uterine wall and cannot be detached during manual detachment, and postoperative pathological diagnosis is based on whether or not the placenta villi have penetrated through the underlying meconium to invade the myometrium. It is important to increase the rate of prenatal diagnosis of placenta previa complicated by placenta implantation. Termination of pregnancy by cesarean section is always used for aggressive placenta previa, which should be fully prepared and guaranteed by a team of experienced obstetricians and anesthesiologists; intraoperative treatment of obstetric hemorrhage can be standardized according to the uterine contraction, placental adhesion, implantation, and hemorrhage, or even decisive resection of the uterus, to save the patient’s life.