Advanced Maternal Age
Advanced maternal age simply means the mother will be 35 or older at
the time of delivery. As a woman gets older the risk for certain
conditions such as Down syndrome gradually increases. Genetic counseling is available to discuss these risks in more detail. Screening and diagnostic testing options are also available to assess the risks and/or determine whether the baby is affected.
Diabetes is a medical condition where an individual has elevated
levels of glucose (sugar) in their blood. There can be multiple
factors, which play a role in the development of diabetes including
genetics/family history, diet, exercise, etc. Some women have diabetes
prior to getting pregnant while other women can develop diabetes just
during the pregnancy known as gestational diabetes. Having uncontrolled
diabetes can cause complications during pregnancy including an increased
risk for certain birth defects for the baby such as heart defects
and/or delivery complications such as large for gestational age babies,
etc. Careful monitoring throughout pregnancy can be helpful for
minimizing these complications.
Hypertension is a medical condition in which blood pressure remains
abnormally high (a reading of 140/90 mm Hg or greater). There can be
multiple factors, which play a role in the development of hypertension
including genetics/family history, diet, exercise, etc. Some women have
hypertension prior to getting pregnant while other women can develop
hypertension just during pregnancy known as pregnancy induced
hypertension. Hypertension can cause complications during pregnancy
including growth problems for the baby, and preeclampsia.
The cervix is the lowest part of the uterus that extends into the
vagina. Cervical incompetence is a condition when a woman’s cervix opens
too early and may cause preterm labor or second trimester miscarriage. A
woman may have an incompetent cervix due to a congenital (present at
birth) abnormality, connective tissue disorder, trauma or damage from a
cone biopsy, LEEP procedure or other cervical surgery, or other
unidentified cause. In some cases a band can be placed between the
uterus and vagina (cerclage) to keep the cervix closed and allow the
pregnancy to progress to term.
Preeclampsia is a complication of pregnancy associated with
hypertension, fluid retention, and excess protein in the urine. If left
untreated, preeclampsia can lead to eclampsia – a serious complication
that can cause seizures and coma. Most commonly if the hypertension
cannot be controlled, then treatment requires delivery of the baby to
prevent serious medical complications for the mother.
Teratogens are substances that can cause a birth defect if your
developing baby is exposed during pregnancy. These may include
infectious agents (rubella, cytomegalovirus, varicella, herpes simplex,
toxoplasma, syphilis, etc.), maternal health factors (diabetes, maternal
PKU), environmental chemicals (organic mercury compounds, herbicides),
and/or drugs (prescription, over- the-counter, recreational). The dose
and the time of exposure to a particular substance often determines
whether or not the baby will be affected and to what degree. In general,
the first trimester is a more vulnerable time for the baby than the
second and third trimesters.