AGE OF THE FIRST PREGNANCY

[Arinarina]

Whether there is in modern medicine a unequivocal opinion concerning when it is necessary to give birth or travail to the first child: when *quot; already ???*quot;, when *quot; already very much ?N?aON?y?*quot;, when *quot; pozdnovato, but nO?O??*quot;, and when *quot; already ?n?*quot;? Or it in a greater degree depends not on age, and from the general or common state of health and, accordingly, risk of development of complications?



At me a situation such: to me now 29 years, but for economic reasons we plan pregnancy and labors not earlier than year through 2-3 that is then to me there will be 31-32 years. It will be the first child. Yes, still I had an abortion in 21 year and a negative rhesus. Now I accept femoden. The State of health good, is not present chronic diseases, I am engaged in physical culture, weight in norm or rate, and on a kind nobody gives me of more than 21-22 years. But (making related and employees) in eager rivalry me convince many, that to me even already pozdnovato, it was necessary to do or make all till 25 years, and now I shall be considered *quot; ?OaOOnnUN*quot;:) also that it is necessary to give birth or travail urgently, but I while do not want, both I can not, and I do not feel need or requirement, EARLY to me STILL!!!:D

Whether something (if threatens) threatens me such spirit on the first child in 32 years? In fact like as in the Europe and this age for the first sorts or labors is considered the USA absolutely normal...

And if there is a risk of complications, whether it is possible to undertake something already now to reduce it or him to a minimum?

[Michelle]

Whether there is in modern medicine a unequivocal opinion concerning when it is necessary to give birth or travail to the first child: when *quot; already ???*quot;, when *quot; already very much ?N?aON?y?*quot;, when *quot; pozdnovato, but nO?O??*quot;, and when *quot; already ?n?*quot;? Or it in a greater degree depends not on age, and from the general or common state of health and, accordingly, risk of development of complications?



At me a situation such: to me now 29 years, but for economic reasons we plan pregnancy and labors not earlier than year through 2-3 that is then to me there will be 31-32 years. It will be the first child. Yes, still I had an abortion in 21 year and a negative rhesus. Now I accept femoden. The State of health good, is not present chronic diseases, I am engaged in physical culture, weight in norm or rate, and on a kind nobody gives me of more than 21-22 years. But (making related and employees) in eager rivalry me convince many, that to me even already pozdnovato, it was necessary to do or make all till 25 years, and now I shall be considered *quot; ?OaOOnnUN*quot;:) also that it is necessary to give birth or travail urgently, but I while do not want, both I can not, and I do not feel need or requirement, EARLY to me STILL!!!:D

Whether something (if threatens) threatens me such spirit on the first child in 32 years? In fact like as in the Europe and this age for the first sorts or labors is considered the USA absolutely normal...

And if there is a risk of complications, whether it is possible to undertake something already now to reduce it or him to a minimum?



Optimum age for the first child approximately with 18- till 26 years. From 26 years the woman is considered *quot; elderly NOoOnnUN*quot;, with 30- - old pervorodjashchej. It is difficult to tell or say from what depends more, since degrees of disturbance of health too happen different, here it is necessary to approach or suit individually in each concrete case. Abortion burdens your anamnesis. Group of a blood too. In general, certainly, 32 years for the first child late. However, here there are no precise rules - happens, as in 35 give birth or travail normally, and happens, that in 20 there are complications. But, as I have already noted, the risk after 26 raises or increases.

[Jury Petrovich]

Forgive or Excuse, the risk of that raises or increases after 26 years? And why it *quot; certainly 32 years for the first child ?n?*quot;? Generally anywhere in the world very young 26-years women are not considered elderly or starorodjashchimi (a directly impolite terminology). To pregnant women after 35 usually offer amniotsentez as the risk of some congenital diseases increases a little or is a little enlarged. After that age according to is a little bit more often there are also complications of pregnancy.

[AnnfanShakira]

All the same authors of domestic classification did not put the purpose to offend the pregnant woman in the age of for 30, but wanted..., and have received as always. Division of pregnant women on age is conditional enough, it was supposed, that with the years % of sorts or labors with complications will increase, but really obvious tendency to that is not present. Classification exists only in a domestic variant, - again in my opinion, not the most successful sample Russian (is more exact, Soviet) ingenuities.



Negative Rh if after abortion has been entered anti-Rh0 (D) Ig too should not be an occasion for acceptance of emergency measures, and the more so - for any preventive treatment (here it is necessary to pay attention to a break between beremennostjami - the he more, the better). Immunization after the termination or ending beremenosti (it is not important, sorts or labors or abortion) occurs or happens prbl at 10 % of women, but further this subject to continue it is not necessary.



As a whole, pregnancy should be planned when personally you to it or this are ready.

[** Igor_T **]

Recently has heard, that the risk of with the years raises or increases that the first child will have an illness or a disease of the Down, and has been told or said (not by the doctor), but *quot; after 30 years raises or increases in hundreds Oa?*quot;! Also that this risk depends only on age and from what more (as such that the risk can and raise or increase with the years is possible or probable, in fact, in any way does not speak that he depends on age!).

[We]

There is higher risk after 35 years and certainly he not in hundreds times - is usual for exception of disease carry out in the first trimester of research of hormones, and at suspicion - do or make amniotsentez.

[valek2381]

Amniotsentez offer all pregnant women after 35 years. For women 35 years risk of this procedure less than risk of the certain diseases of the child which can be revealed by means of this procedure are more senior. For women 35 years - on the contrary are more younger.



And Triple test it is offered to all women irrespective of age. You are right.

[Mery]

At present, the standard of care in the USA is to offer pregnancy screening for chromosomal anomalies and spina bifida by a blood test to all women, followed by prenatal cytogenic diagnosis if indicated. The combined serum test (measurement of alphafetoprotein, human chorionic gonadotropin, and unconjugated oestriol in maternal serum) in the first trimester has a 69 % detection rate and a 5 % false-positive rate. Research efforts now focus on improvement of the sensitivity and specificity of screening, to reduce or eliminate the number of women needing an invasive diagnostic test, such as chorionic-villus sampling or amniocentesis. The combined use of maternal serum screening with fetal ultrasound testing for a thickened nuchal fold may have an 80-85 % detection rate with a 5 % rate of false-positives. Use of fetal cells in the maternal circulation for prenatal diagnosis could eliminate the need for amniocentesis in diagnostic testing; however, isolation of fetal cells from maternal blood is still associated with several technical and biological difficulties.



Lancet. 2003 Apr 12; 361 (9365):1281-9.

Down's syndrome.

Roizen NJ, Patterson D.

[JAn]

Women at increased risk of aneuploidy should be offered prenatal diagnosis by amniocentesis or CVS. Persons at increased risk include women who will be older than 35 years at delivery and have a singleton pregnancy (older than 32 years for women pregnant with twins); women carrying a fetus with a major structural anomaly identified by ultrasonography; women with ultrasound markers of aneuploidy (including increased nuchal thickness); women with a previously affected pregnancy; couples with a known translocation, chromosome inversion, or aneuploidy; and women with a positive maternal serum screen. Amniocentesis may be performed after 15 weeks' gestation and is associated with a 0.5 percent risk of spontaneous abortion. CVS is performed at 10 to 12 weeks' gestation and has a 1.0 to 1.5 percent risk of spontaneous abortion. CVS may be associated with transverse limb defects (1 per 3,000 to 1 per 1,000 fetuses). Women undergoing CVS also should be offered maternal serum a-fetoprotein testing for neural tube defects. Women older than 35 years may opt for serum screening and ultrasonography before deciding whether to proceed with amniocentesis. The family physician is in an excellent position to discuss the ethical issues of genetic screening within the context of the patient's values.



http: // www.aafp.org/afp //20050401/1307.html

[nazareth_vs]

http: // www.womens-health.co.uk/downs.asp



Amniocentesis

Down syndrome can be diagnosed early in pregnancy (at about 15-16 weeks) by amniocentesis. This involves a very fine needle being passed into the womb, under guidance by ultrasound, and sampling of the (amniotic) fluid around the baby. It is done under local anaesthetic, and most women do not find it too uncomfortable. There is a risk, however, of about 1 in 100 to 200 of a spontaneous miscarriage after the procedure.



Because of this miscarriage rate, amniocentesis is only offered to women deemed to be at high risk of having a baby with Down syndrome. Similarly, it must be something that you have thought about at length, discussed with your partner and feel that you would opt for a termination of the pregnancy, were you found to be carrying a baby with DS. Clearly, if this is not something you would consider, then you most likely would not wish to risk miscarriage, just to know. It is also important to remember that people with Down Syndrome can have long, fulfilling lives. There are a lot worse things that can happen.



Who is high risk then?

Until recently, the only factor used to identify women at high risk for DS was their age. At age 40, for example, the chance of having a baby with DS is about 1 in 100. This has led to many hospitals offering amniocentesis to women over a certain age, usually 35 or 37. The problem with this is that it only will identify 15-30 % of all cases of DS; the majority still occur in women who are younger (because there are more of them having babies, even though, individually their risk is less).

[Black Dragon]

Usually for exception of disease carry out in the first trimester of research of hormones

In the second. 13-15 weeks.

[Vick]

In the second. 13-15 weeks.



I think, terms of carrying out of testing depends both on the country and from clinic:



Most physicians use the mid-trimester maternal serum screen, which measures human chorionic gonadotropin (hCG), unconjugated estriol, and a-fetoprotein levels at 15 to 20 weeks' gestation (optimal timing is 16 to 18 weeks' gestation). The maternal serum screen is approximately 65 percent sensitive for detecting aneuploidy and 95 percent specific. In some centers, fetal nuchal translucency can be measured by ultrasonography combined with maternal serum analyte levels (i.e., free hCG and pregnancy-associated plasma protein A). This testing can be performed at 10 to 14 weeks' gestation. Sensitivity and specificity of these tests is determined by the risk cutoff used (e.g., for trisomy 21, sensitivity is 85.2 percent when specificity is 90.6 percent; at 95 percent specificity, the sensitivity is 78.7 percent). An integrated screening protocol using first-and second-trimester markers is being used in some areas.



http: // www.aafp.org/afp //20050401/1307.html

[**]

In the second.



I think, terms of carrying out of testing depends both on the country and from clinic:



Most physicians use the mid-trimester maternal serum screen, which measures human chorionic gonadotropin (hCG), unconjugated estriol, and a-fetoprotein levels at 15 to 20 weeks' gestation (optimal timing is 16 to 18 weeks' gestation).

Certainly, depends on clinic, and from the country too. 15 - 20 weeks - just the second trimester.

[mementolga]

15 - 20 weeks - just the third trimester.



Always it seemed to me, that if normal pregnancy is expected 36 weeks and in her 3 trimesters the first comes to an end 12-th week, about 13-th on 24-th - the second, and the third trimester from 25-th week.

[Sojkina]

Always it seemed to me, that if normal pregnancy is expected 36 weeks and in her 3 trimesters the first comes to an end 12-th week, about 13-th on 24-th - the second, and the third trimester from 25-th week.

I am sorry, I wished to confirm words tatabox about the SECOND trimester and was sealed up, now podredaktiruju.