Summary of Consensus Recommendations
✔️We suggest that pregnancy with anticipated delivery at age 35 years+ be recognized as a risk factor for adverse maternal, fetal, and neonatal outcomes when counseling patients and determining management plans.
✔️We recommend daily low-dose aspirin for preeclampsia prevention for pregnant individuals aged 35+ 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+, we suggest a first-trimester ultrasonogram.
✔️We recommend that prenatal genetic screening and diagnostic testing options be discussed and offered to all pregnant individuals regardless of age or risk of chromosomal abnormality. After review and discussion, every patient has the right to pursue or decline prenatal genetic screening and diagnostic testing.
✔️We suggest a detailed fetal anatomic ultrasonogram for pregnant individuals with anticipated delivery at age 35 years+ given the increased risk of aneuploidy and potential increased risk of congenital anomalies in this population.
✔️Due to increased risk of both large-for- and small-for-gestational-age neonates, we suggest an ultrasonogram for growth assessment in the 3rd trimester for pregnant individuals with anticipated delivery at age 40 years+.
✔️We suggest offering antenatal fetal surveillance for pregnant individuals with anticipated delivery at age 40 years¥ given the increased risk of stillbirth.
✔️We recommend proceeding with delivery in well-dated pregnancies at 39 0/7–39 6/7 weeks of gestation for individuals with anticipated delivery at age 40 years+ due to increasing rates of neonatal morbidity and stillbirth beyond this gestational age.
✔️We suggest counseling that 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.
***********************************
Check out these resources:
1. [ Ссылка ]
***********************************
Welcome to my channel and be sure to hit “subscribe”!
I am a double board certified ObGyn and Maternal-Fetal Medicine specialist focusing on the care of people with maternal and/or fetal complications of pregnancy. I discuss hot topics related to fertility, pregnancy and the postpartum period, and do a little myth-busting and fact-checking to keep things real! Not only am I a doc, but I was also a patient who had infertility, a high-risk twin pregnancy and preterm delivery, and NICU stay at age 43 as a first-time mom--so I GET IT! Leave requests for new topics in comments!
***********************************
Follow me on social media and elsewhere!
Instagram: [ Ссылка ]
TikTok: [ Ссылка ]
Twitter: [ Ссылка ]
Podcast: [ Ссылка ]
Email: smclarkmd@gmail.com
***********************************
DISCLAIMER: This channel is provided for educational and informational purposes only and does not constitute providing medical advice. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with their physician or other healthcare provider. Views expressed here do not represent the views of Dr. Clark's employer.
Fact checking @justinsloanemd!
#ama #advancedmaternalage #pregnancy #over40 #over35
![](https://s2.save4k.ru/pic/6u7P11jG6l4/maxresdefault.jpg)