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Late pregnancy: medical aspect
Pregnancy - one of the most important and joyful events in the woman`s life. But, as well as all most important, this event involves not only pleasure, hopes and expectations, but also it is a lot of experiences and fears. And with age these experiences become more and more. Unfortunately, not all alarms of future mothers who stepped 30 - 35 - a summer boundary, are groundless.
Optimum for the birth of the first child the age period from 20 to 30 years is considered. For the subsequent childbirth the best interval of 3 years. During this time the organism of the woman manages to be restored, that is to pass the rehabilitation period after the delivery.
In obstetric practice is available the specific term “age pervorodyashchy“ which designates the women who for the first time are giving birth at the age of 30 years and is more senior. However more and more women around the world postpone motherhood for the fourth ten life. The reasons can be different, but at most of women this desire to reach a certain social and professional status, to promote before completely devoting itself to a family. On a sample of other countries where women only begin to give birth in thirty five, and sometimes and in forty years, our women who gave birth to the first child aged between 30 and 40 years for the last twenty years became 3 times more. Today everyone 12 - go the child is given birth by the woman 35 years are more senior. For quarter of the century for 90% the number of women in labor among women of 35 - 39 years increased, the number of mothers who are 40 years old and more increased by 87%. Even such famous conservatives as doctors, for the sake of mature mothers softened the formulations: before them called “starorodyashchy“, “age“ now. In increasing frequency there are opinions that as “age“ it is necessary to consider the women who for the first time are giving birth aged 35 years are more senior. Everything is good, but such late pregnancy, alas, conceals in itself a set of medical troubles.
the Most important problem of women of not too early age is infertility. So, if at the woman 30 years chance to become pregnant during one monthly cycle are younger makes 20%, then at the woman is more senior 40 - only 5%. About 30% of women are more senior than 35 years in general are fruitless. Why? First of all it is connected with the age changes of tissues of uterus and ovaries involving decrease in their functional features. For anybody not the secret that we grow at most till 25 years, and occurs natural aging of a human body further. It is expressed not only externally - in our small wrinkles on a face and a body. Age changes of an organism first of all concern blood system and at the same time are shown, first of all, in insufficiently working bodies.
In particular, at the young women who are not giving birth for many years internal genitals are in a condition of functional insufficiency and therefore are exposed to presenilation. Since 28 - 30 - summer age in uterine tubes of women there are changes of small arteries; besides, hems and solderings around uterine tubes and in them are formed with age. Frequency of such changes at the women having inflammatory diseases of a uterus, pipes, ovaries is especially big. It results in impassability of pipes at which hit of an ovum in a cavity of a uterus becomes impossible. It is possible to fight against these changes with modern microsurgery. Besides, with a current of years an increasing number of menstrual cycles passes without formation of an ovum, and approach of pregnancy in such cycle, naturally, is impossible. During this period quality of ova considerably decreases and the number of defective ova increases. Reduce probability of pregnancy, from - for death of ova, smoking, chemotherapy, radiation therapy.
the Additional factor reducing reproductive ability of the woman with age is also reduction of “uterine fertility“ - abilities to conception, caused by decrease in inflow of blood to a uterus and ovaries, reduction of a susceptibility of a uterus to hormones and some chronic diseases (myoma - - a benign tumor of a uterus, chronic inflammatory processes, endometriosis growth an endometriya, an inside layer of a uterus, in places uncharacteristic for this purpose). These diseases not only interfere with implantation of an embryo, but also cause problems of incubation of the come pregnancy.
Touching upon a pregnancy subject at mature age, it is necessary to tell about women for whom an opportunity to become pregnant by means of medicine became the only chance to test happiness of motherhood. Among EKO (extracorporal fertilization) addressing to clinics there are a lot of women for 30 and even for 40. Chances to give rise at such women of time in two it is less, than at young people, but it though some chances in comparison with the diagnosis which sounded a ruthless sentence 20 years ago. Certainly, development of auxiliary reproductive technologies, first of all extracorporal fertilization, - one of the factors which caused growth of number of late pregnancies and the “grown old“ young mothers.
Pregnancy came. But together with feeling of a miracle future mummy is waited by new disorders. And first of all it concerns that after 30 years, is especially closer to 40, the risk increases to give birth to the child with congenital pathology. Among them and heart diseases, zheludochno - an intestinal path, kostno - muscular system, and quite often found Down syndrome. It is connected with various and not up to the end studied reasons among which it is possible to note both aging of gametes, and time of impact on a human body of various harmful factors and toxic substances increasing with age., naturally, is not present
of Absolute dependence between age and pathology. The risk of any genetic disorder as a result of a casual mutation is present always even at the young woman. But with age the mechanism allowing to distinguish a healthy embryo from the patient and if the young organism more often just tears away such fruit is broken, then after critical age of spontaneous mutations becomes more, and the protective mechanism not always works. So, the probability of the birth of the child with a Down syndrome at 25 - the summer woman makes 1 case from 1250, at 35 - summer - 1 of 378, and at 45 summer - 1 of 30. About 70% of all children with a Down syndrome gave rise women 35 years are more senior.
Considering such risk, some couples even before conception find out a possibility of this or that option of chromosomal anomalies. But complexity consists in what before pregnancy cannot be predicted and to precisely predict a possibility of conception of the kid with this or that chromosomal pathology including with a Down syndrome, it is possible to calculate degree of risk of emergence of pathology only. In respect of prevention of spontaneous mutations reception of vitamin preparations, in particular vitamins of group B and folic acid helps. Most of doctors recommend to do it in three months prior to conception.
“Age“ mother surely consults at the geneticist during pregnancy.However the genetics prepares
for future mummies for 30 not only problems, but also pleasant surprises. So, pregnancy by twins or triplets (even if you were treated for infertility) happens to a thicket at this age. And the peak of twin childbirth is the share of age of 35 - 39 years.
And how with health?
One more reason for concern is an exacerbation of all chronic diseases which were descended to the woman or were acquired for all antecedents, Special vigilance women with warmly - vascular diseases (arterial hypertension - increase of arterial pressure, heart diseases), chronic diseases of lungs (pneumonia or bronchitis, bronchial asthma, etc.) and kidneys (chronic pyelonephritises), with endocrine diseases cause in obstetricians (diabetes, diseases of a thyroid gland, adrenal glands, etc.) . If the woman had some chronic disease which it seems and did not bring upon her special trouble, during pregnancy it by all means will remind of itself. And first of all, alas, it is necessary to find out whether pregnancy at this pathology is contraindicated in principle.
But frequent to have the desire of the woman the child much stronger than understanding of risk at which it itself puts during pregnancy. In 2 - 3 months prior to alleged pregnancy it is necessary to treat chronic diseases if it is necessary. As bodies of a fruit are formed in the first 12 weeks of pregnancy, treatment of chronic diseases from the beginning of pregnancy will not bring big benefit to future child. It is better to be observed on pregnancy to women with chronic pathology in the special centers.At women 40 years by 3 times are more senior than
more often than to 30, diabetes of pregnant women develops. At the women sick with diabetes, during pregnancy the risk of a gestoz, a still birth and specific defeat of a fruit increases. Diabetes of pregnant women demands observance of a diet and performance of special purposes of the endocrinologist.
of Complication of pregnancy
First what it is necessary to tell about, is, of course, increase in probability of an abortion. If at women the 30th risk of an abortion is younger than 10%, then at women of 30 - 39 years it makes already 17%, and at women of 40 - 44 years increases up to 33%. The risk of not incubation of pregnancy is connected not only with age changes of all female organism, but also with genetic disorders, and also with hormonal features. Also such problems as chronic placentary insufficiency, prelying, a premature otsloyka of a placenta are possible. They are one of the reasons of a pre-natal hypoxia of a fruit, the birth of the small baby, and also a background on which the premature and complicated childbirth develops.by
It is given birth?
Childbirth at women after 30 also has the features among which there is a high probability of weakness of patrimonial activity, bigger risk of ruptures of soft patrimonial ways owing to reduction of elasticity of fabrics, bleedings.
From - for weak patrimonial activity childbirth can come to an end Caesarian with section. Doctors consider this method more sparing both for health of the child, and for health of the mother. However the belief that on the fourth ten in the natural way nobody gives birth, is a myth. If it is only about an age factor, childbirth passes through natural patrimonial ways. The decision on planned Cesarean section follows usually from set of factors. For example, at the woman the long time was observed infertility, and fears for life of the long-awaited kid are very strong. It is serious argument in favor of Cesarean section.
Difficult and long childbirth becomes for those women at whom elasticity of muscles and elasticity of joints decreases with age. Active lifestyle is especially actual for “late“ mothers: it is more movements, swimming, special gymnastics, especially than exercise on training of muscles of a crotch.