New indications for antepartum testing: making the case for antepartum surveillance or timed delivery for women of advanced maternal age.
Maternal age is an independent risk factor for stillbirth; a moderate number of these occur in normally formed babies near term. For a woman 40 years of age or older giving birth, her risk of having a chromosomal anomaly is 1/66. What is not appreciated is that even without medical risk factors, her risk of having a stillbirth after 37 weeks of gestation is 1/116. This article reviews the risks and benefits of the strategy of antepartum testing and timed delivery and discusses the limitations of the available data in this field.
Fretts
Ruth C
RC
Harvard Vanguard Medical Associates, Brigham and Women's Hospital and Newton Wellesley Hospital, Wellesley, MA 02481, USA. Rfretts@vmed.org
Duru
Ugonna A
UA
D036861:Delivery, Obstetric; D005260:Female; D005313:Fetal Death / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012307:Risk Factors; D050497:Stillbirth