Dr. Yasmin AboElazm provides expert insights for pregnant women over 40

To explore deeper into this topic, we interviewed Dr. Yasmin Mohamed AboElazm, an expert in obstetrics and gynecology. With her wealth of experience, Dr. Yasmin provides valuable insights into the latest medical advancements and key considerations in maternal healthcare for mothers over 40. She discusses the heightened genetic risks, typical complications, and proactive measures during pregnancy. Additionally, she emphasizes the importance of lifestyle adjustments and medical interventions for mothers over 40, highlighting the evolving landscape of obstetrics and gynecology. Our aim with this interview is to enhance understanding and empower women to make informed decisions about their reproductive journey.

Dr. Yasmin AboElazm Guidance for Pregnant Women Over 40!

1. Before we delve into our discussion, we would appreciate it if you could introduce yourself and provide some insight into your background and experience in obstetrics and gynecology?

My name is Yasmin Mohamed AboElazm, Graduated from Mansoura medical school since 2013 and have been working in Obstetrics and gynecology since 2016, I had my masters degree from Mansoura university.

2. Lately, many women's mindsets have changed, and they see that age is just a number, believing they can get pregnant at any age. What is your perspective on this common belief among many women today? How would you advise women who hold this belief regarding their reproductive health and fertility?

At first we need to shine light on how fertility differs from one woman to another, but generally fertility peaks at 20s and early 30s then starts to decline after 35 years old till we reach 45 years old when natural conceiving becomes little impossible, as we grow old so does our ovaries and eggs therefore my advice would be if you are interested in getting pregnant someday I won’t advice on delaying it after the age of 35 or at least consider oocyte freezing before the age of 35.

3. What physical changes occur in women's bodies as they age, particularly concerning their ability to conceive and carry a pregnancy?

The quality of eggs and genetic material gets affected by age and flaws incidence start increasing after 38 years old plus the possibility of developing medical complications with pregnancy increase with age as pre-eclampsia and gestational diabetes.

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4. Could you please discuss the primary health risks and difficulties associated with getting pregnant after the age of 40, both for the mother and the baby?

High blood pressure possibility increases with age and that puts the woman at risk of developing pre-eclampsia, also the risk of miscarriages and still birth increase with advanced age, as for the fetus after 40 the possibility of having a baby with a chromosomal abnormality as Down syndrome or Pateau syndrome increases.

5. How does being an older mother affect the success rates of fertility treatments like In vitro fertilization (IVF) and other assisted reproductive methods?

Getting older means lower ovarian reserve which means your ovary will produce lower number of eggs in response to ovulation induction, plus the lower quality of eggs will mean increased possibility of having a baby with chromosomal abnormality as Down syndrome.

6. Could you explain the higher likelihood of genetic issues, like Down syndrome, in pregnancies of women over 40? How do doctors evaluate and handle this risk?

Above 40 years old the risk of down syndrome increases to be 1 in 84 pregnancy which is a very high risk, prenatal testing may give us insight regarding the genetic disorders but first trimester screening give us a possibility of diagnosis up to 84% but there is no 100% test that can assure us of the presence or absence of it, recently there is NIPT that can be done as early as 10 weeks pregnancy and give us high accuracy in whether the fetus have a chromosomal abnormality or not.

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7. What are some typical complications that older pregnant women might encounter, and what steps are taken to address them during pregnancy and childbirth?

The most common complication is Pre-eclampsia and we prescribe something like low dose aspirin at some point during pregnancy to decreases its risk, women after 40 may need extra antenatal visits also guidelines recommend induction of labor at 39 weeks GA to avoid the risk of stillbirth.

8. How does the risk of gestational diabetes and preeclampsia change with age, and what can be done to lower these risks?

The risk of having higher blood pressure increases with age therefore the risk of pre-eclampsia, the same applies on increased insulin resistance, having a healthy lifestyle and weight, cessation of smoking and having a healthy diet with good antenatal care with decrease its risk plus early detection of disorders will give us a chance of good management.

9. Are there lifestyle changes or medical treatments recommended for women over 40 to increase their chances of having a healthy pregnancy and delivery?

Maintaining a healthy lifestyle more likely will preserve the fertility and protect against most of the maternal medical disorders that may increase with age. 

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10. Can you talk about any recent breakthroughs or advances in obstetrics and gynecology that have made a difference in the outcomes for older mothers and their babies?

The advances mainly are new tests that will give us a more accurate prediction of anomalies and fetal syndromes during pregnancy which will affect the outcome and how will we deal with it after giving birth.

11. How do you approach counseling and support for women who are thinking about getting pregnant later in life, considering their unique health history, fertility, and the risks associated with pregnancy at an older age?

Providing true and honest information regarding the effect of age and lifestyle on fertility is very important for women to make a decision about how will they want to continue, as I have said before oocyte freezing is relatively new and very helpful for women to do at a younger age to maintain their good ova for a more healthy pregnancy later in life, cessation of smoking and maintaining a healthy weight and level of fitness is very important for having a healthy pregnancy at any age specially after 40, and I always say that there’s no impossible but it is always wise to take precautions when there is a risk.