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A Comprehensive Approach to Care of Women of Advanced Maternal Age
Authors:Carrie M. Dillon  Christopher S. Ennen  Kathleen J. Bailey  Andrew S. Thagard
Abstract:Advanced maternal age, historically defined as ages 35 years and older, is used to describe the later years in the female reproductive life span when rates of adverse pregnancy outcomes increase. The preconception period represents an opportunity to ensure the use of safe medications and optimize care for medical comorbidities. Routine prenatal care should be augmented with counseling on fetal aneuploidy with a detailed anatomic survey. Surveillance for preterm labor and preeclampsia is recommended. Growth assessment and antepartum testing for specific women are advised, particularly those ages 40 years and older and those with select medical problems. Despite an increased incidence of complications, most women of advanced maternal age will have normal pregnancies and will benefit from the compassionate care provided by midwives, advanced practice registered nurses (including nurse practitioners and clinical nurse specialists), and perinatal nurses.
Keywords:advanced maternal age  antepartum care  fetal aneuploidy  obstetric complications  pregnancy  preventive health care  screening and diagnostic tests
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