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Maternal-Fetal Medicine:
Managing High-Risk Pregnancies

HealthReach, Fall 2012 | Page 4

Busy careers and later marriages are prompting many women to wait until they are older to have a baby. The majority of these moms will deliver perfectly healthy babies. However, any woman who will be 35 years or older at the time of her due date is considered to be a high-risk pregnancy. In the Maternal-Fetal Medicine Department at Virginia Hospital Center, perinatologists Carolina Reyes, MD and Rizwana Fareeduddin, MD work closely with a patient's OB/GYN and the NICU's neonatologists to manage care for mom and baby when necessary.

Once a women 35 or older becomes pregnant, non-invasive screenings are routine in the first and second trimesters to check for chromosomal disorders. Ultrascreen is a sonogram that measures the thickness of the fetus’s neck. A baby with Down’s syndrome will have extra fluid in this area. In addition, a finger stick blood test checks hormone levels to detect increased risk of certain birth defects. These screening tests can detect Down’s syndrome with 80 to 85 percent accuracy.

Women over 35 have a higher rate of C-sections, although the chances of a successful vaginal delivery are higher in moms who have had previous vaginal births without complications. Virginia Hospital Center is equipped to manage all kinds of pregnancies and deliveries, including those few that end up being high-risk.

If you are considering getting pregnant, follow these tips to ensure you are in tip-top shape before you conceive:

See your doctor first

Make sure you’re healthy, your vaccines are current, and any medical conditions, such as diabetes and high blood pressure, are under control.

Take folic acid

This B vitamin plays an important role in new cell growth and reduces the chance of brain and spinal cord defects, such as spina bifida. By the time you discover you are pregnant, the baby’s neural tube has almost completely developed. So, it’s important to begin taking folic acid at least three months before conception. Take a vitamin with folic acid or eat a bowl of cereal that has 100 percent of the daily value of folic acid every day.

Brush and floss

Bacteria in the gums can travel through the blood stream to the baby and cause systemic infection.

Avoid smoke

This includes not only smoking, but secondhand smoke.

Do not drink alcohol

Even tiny amounts can be harmful to a fetus, particularly in the first trimester.

Don’t wait too long

Fertility does start to decrease after 35. The sooner women begin trying to conceive, the better the odds of spontaneous pregnancy. Every six months makes a big difference.

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