Pregnancy and age

  : : I just had the blood test and it shows positive for pregnancy. I am
  : : 40 years old. I am worried about having a good pregnancy. I've been told
  : : by friends that I should take some additional tests to insure all is well.
  : : What tests are recommended? Is there any other information I should know
  : : dealing with pregnancy and my age? Thanks
  : Dear Levy:
  : Although our preference is for women to take folic acid before conception, it is never too late: 1 mg daily as a supplement. Check with your physician regarding any medications you may be taking.
  : After age 35 years, the risk for "abnormal chromosomes" is increased to the level that we recommend "Prenatal Diagnosis". Several tests are used: Maternal Serum Alpha-Feto Protein (MSAFP) is a blood test done at 15 weeks gestation. A Chorionic Villous Sample (CVS) takes some of the cells from the early placenta around 10-11 weeks' and they are analyzed for their chromosome number. The same chromosome information can be gained by removing a sample of amniotic fluid (Amniocentesis) between 16 and 20 weeks. Finally, an ultrasound study at 18 weeks' gestation allows a screen of the baby's anatomy (heart, kidneys, fingers, toes, etc).
  : Books such as "What To Expect When Your Are Expecting" can prepare you for the months ahead.
  : Keywords: Pregnancy, age>35 years
  : This information is provided for education only and is not a medical consultation. If you have specific questions, please contact your physician.
  Thanks for the info.  Is there a reason to take both the CVS and Amniocentesis? Is one more dangerous than the other?
Dear Levy:
A CVS is done at 10 weeks gestation. The advantages are more rapid answers at a time when pregnancy termination is easier. If the information is uncertain, an amniocentesis can be done as a second assessment.
Amniocentesis is still regarded at the "gold standard". There is debate regarding the CVS safety: this is a time when miscarriage is still very common and thus it is hard to know if an unwanted event is caused by or merely conincident with the CVS. The risk of miscarriage is about 2/100. The risk of miscarriage following amniocentesis is about 1/1000.