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Increasing the level of education and participation of women in economic life, such as the reasons for increasing the age of motherhood. The last 30 years in Turkey as in many countries of that age at first birth increased to 30s from 20s pointing to the International Hospital of Gynecology and Obstetrics, IVF Department Head Dr. İsmail Çepni says: “Many mothers are in their 30s, She's the first mother in her 40s. At this age, among the public 'tosuncuk' called, 4 kg and more baby birth rate is also increasing. However, 'tosuncuk' babies born with this weight are not born only for genetic reasons such as long and big parents. Some of the risks that arise in the mother's health can lead to large babies. ”
Formerly 35-year-old pregnancies 'elderly pregnancy' Prof. Dr. Özdemir stated that this definition is now made for pregnancies over 40 years of age with the prolongation of human life and the increase in quality of life. Dr. İsmail Çepni answered questions about pregnancies 40 years and older:
How Do Pregnancy Rates Change at What Age?
• Compared to the 1980s, the rate of becoming a mother for the first time over the age of 30 increased threefold, 6 times over 35 and 15 times over 40 in 2000s.
• As women age with natural ways chance of pregnancy decreasing. Every month, 20 percent of those who do not use birth control in their 20-30s, who enter into regular relationships and want children are successful.
• This rate decreases to 15 percent at the age of 30 and to 10 percent at the age of 35.
• 40 years old while this rate goes down to 5 percent. Reproductive help (such as in vitro fertilization) treatments and especially with the help of egg donation can be conceived by using someone else's eggs, close to menopause, post-menopausal pregnancy becomes possible even in old age.
• Most pregnancies after the age of 40 occur with the contribution of reproductive aids. All of the postmenopausal women are 'egg donation' from another woman.
What are the risks of getting pregnant after the age of 40?
There are changes in the body of the expectant mother during pregnancy, which can be called extraordinary but can be tolerated and adapted by healthy and young people. However, after the age of 40 pregnant women; cardiovascular, respiratory, kidney, skeleton, breast, skin and gynecological organs, especially the uterus, especially every organ system is affected and the burden is increasing. For example, the amount of blood in your body increases by 50%. Therefore, there is a significant increase in the burden of the heart. If there is no health problem and organ reserves are good, there is no problem. However, if there is a health problem, pregnancy is aggravated if the reserves are low.
Late pregnancy other diseases are triggered, systemic diseases where organ reserves are limited do not show symptoms, but they show signs or become more severe during pregnancy. For example, a person with a heart disease can continue his daily life, while the probability of having problems with pregnancy increases. Especially in the 3rd-6th pregnancy. Between the months of the heart can have serious problems. Likewise, lung, liver, kidney diseases in the same situation.
How is the mother affected by pregnancy?
• Aggravates preexisting diseases such as diabetes or hypertension for the mother.
• Pregnant woman hypertension, preeclampsia (pregnancy poisoning), cardiovascular diseases, diabetes are seen more than the youth.
• Most importantly, maternal mortality risk increases with age.
• The risk is about 5-14 times higher than 35 years of age compared to 20-24 years of age.
• The risk of ectopic pregnancy increases with previous infection and surgical IVF applications compared to young people.
• Ectopic pregnancy is still one of the leading causes of maternal mortality in the world.
• The frequency of early separation of the placenta and the leading of the placenta, especially in the third stage of pregnancy, also leads to an increase in bleeding.
How does it affect the baby?
• The risk of miscarriage increases up to 30%.
• In addition, feeding problems are reflected to the baby due to the blood supply problems of the spouse feeding the baby (placenta).
• Early birth or the proportion of babies with growth retardation compared to gestational week, as well as stillbirth is also increasing.
• Mother age The most important risk increase in terms of infant with mongol child is the chance of giving birth. The incidence of Mongolism increases with maternal age.
• This risk is 1 per 10 thousand when the mother is 20 years old, 3 per thousand when the mother is 35 years old and 1 percent when the mother is 40 years old.
• Mongolism and other chromosomal abnormalities are more common in elderly mothers because of the aging of their eggs and their exposure to harmful substances, chemicals, x-rays and infections over time.
How is the Birth of Women Who Have Been Pregnant After 40?
• Maternal chronic diseases, intrauterine growth retardation and preeclampsia occur in advanced pregnancy.
• The fetus suffers from stress due to impaired placental function.
• Neonatal oxygen deficiency can lead to neurological dysfunctions or the death of the baby.
• Pregnant mothers who have had their first pregnancy at an older age take longer to complete all stages of labor than younger pregnant women.
• In addition, the frequency of large infants in pregnant women and the risk of shoulder shoulders increase at birth.
• Almost all pregnancies are terminated by caesarean section in advanced age pregnancies, which is an important factor in increasing cesarean rate today.
• The maternal burden of the elderly mother creates difficulty in adapting to rapid physical changes after birth.
• Birth-related complications increase, such as systemic comorbidities and increased anesthetic problems compared to younger mothers.
• In terms of normal birth, the maternal route of delivery is less flexible compared to the younger ones, so tears, bleeding, urinary incontinence and so on. problems occur more and more.
“Risks can be eliminated by early intervention”
Pregnancy of mothers in their 40s The first measure against risks that may arise is to consult a specialist. Before pregnancy; the anemia, diabetes, thyroid diseases, hypertension, heart disease, lungs, kidneys and other systems in the woman can be solved with detailed examinations and appropriate treatments.
When pregnant, again, the health of both the mother and the baby are monitored with expert follow-up. Regarding the chromosomal and structural disabilities of the baby; In the 12th week of pregnancy, a double screening test and detailed ultrasonography are performed, in the 16th week a triple or quadruple screening test is used today. Genetic characteristics of the baby can be investigated for each candidate of this age by taking samples of the fluid in which the baby lives (amniocentesis at 18-19 weeks), or by taking blood from the baby's cord (cordocentesis) at a later period. In these tests, some metabolic and hormonal diseases can be detected early by looking at some substances.