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#over35andpregnant

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Replying to @Melissa Apodaca Other info from ACOG on pregnancy after age 35! Pregnancy with anticipated delivery at age 35 years or older be recognized as a risk factor for adverse maternal, fetal, and neonatal outcomes when counseling patients and determining management plans. Nuanced counseling will be dependent on specific age and comorbidities. Daily low-dose aspirin for the reduction of preeclampsia for pregnant individuals aged 35 or older in the setting of at least one other moderate risk factor. Given increased rates of multiple gestations for pregnant individuals with anticipated delivery at age 35 years or older, a first-trimester ultrasound is recommended. Prenatal genetic screening (serum screening with or without nuchal translucency ultrasonography or cell-free DNA screening) and diagnostic testing (chorionic villus sampling or amniocentesis) options should be discussed and offered to all pregnant individuals regardless of age or risk of chromosomal abnormality. A detailed fetal anatomic ultrasonogram for pregnant individuals with anticipated delivery at age 35 years or older given the increased risk of aneuploidy and potential increased risk of congenital anomalies in this population is recommended. Due to increased risk of both large-for-gestational-age and small-for-gestational-age neonates, an ultrasound for growth assessment in the third trimester for pregnant individuals with anticipated delivery at age 40 years or older is recommended. Antenatal fetal surveillance for pregnant individuals with anticipated delivery at age 40 years or older given the increased risk of stillbirth should be offered. Delivery in well-dated pregnancies at 39 0/7–39 6/7 weeks of gestation for individuals with anticipated delivery at age 40 years or older due to increasing rates of neonatal morbidity and stillbirth beyond this gestational age is recommended. Vaginal delivery is safe and appropriate if there are no other maternal or fetal indications for cesarean delivery. Counseling should include a discussion of the risks of cesarean delivery, the patient’s comorbidities, and the patient’s preferences and goals. Advancing patient age alone is not an indication for cesarean delivery. #ama #advancedmaternalage #advancedmaternalagepregnancy #pregnancyover35 #pregnancyover40