Pregnant at age 45!

Hi -- I wrote you two weeks ago about whether it was worthwhile to pursue fertility drugs at age 45 and 1/2.  (I recently had a high-normal 3rd-day FSH score of 10, which was the only testing we did.  We have been married/trying to have a baby for a year, and we weren't ready to go ahead with donor eggs.)  Anyway, it turns out I was actually pregnant--without any fertility treatments--as I posted my question!  And now I'm both excited and a little nervous.  Have you got any advice for a woman of my age who is pregnant for the first time?  Is there anything I can do to decrease the risk of miscarriage?  Thank you!

[USF-M.D.-JM]

Ok, your are at a risk of 1 in 5 for a genetic anomaly. The test that should be offerd to you from your Ob or either a CVS or Genetic amniocentesis, both have the same 2% risk of losing the pregnancy from the tests. Both are very accurate. Now if it does not matter if the child has a genetic anomaly ( Down's Syndrome) don't do the test. That is an obvious answer. But I let alot of couples know that if Down's syndrome would not matter than why test, some couples want to know and for some it is meant to be.
Second I would suggest you see a Maternal Fetal Specialist, High Risk OB. Reasons are that you are at a highter risk of gestational diabetes, miscarrage (miscarriage), pre-ecclampsia, etc.
The only thing I can thinking of to limit the risk of miscarriage that you may have control over is progesterone levels. Ovarian progesterone maintains the pregnancy the first ten weeks then the placenta makes progesterone. Progesterone will not maintain a pregnacy that is an inevitable miscarrage (miscarriage) or non compatible with life, mostly those that lack the ovarian vitality to make progesterone.
Obviously, fluids and prenatal vitamins, and get an MFM Ob appointment ASAP.
Congratualtions and all the best,
JM