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ASHEVILLE, N.C. -- When it comes to preconception counseling of women older than 35 years, be honest about the increased risks for complications, but put the information in context and balance it with the appropriate dose of hope and optimism, Dr. James E. Ferguson advised.
For example, rather than telling a 40-year-old woman that the risk of fetal death increases with age--from 4 per 1,000 in those under 30 to 8 per 1,000 in those aged 40 and older--tell her she still has a 99.2% chance of carrying to term, Dr. Ferguson said at the annual Southern Obstetric and Gynecologic Seminar.
That's not to say the risks should be ignored. In fact, there are a number of complications in addition to fetal death that can occur more often in women over 35, including preeclampsia, placenta previa, cesarean section, labor induction, postpartum hemorrhage, intrauterine growth restriction, preterm delivery, low birth weight, a number of fetal malformations, and maternal mortality.
The rate of many of these complications increases with age. But careful preplanning can increase the chances of a good outcome, ...