How do elderly pregnant women give birth to healthy babies?

Two children and three children. The good news is that some elderly women are also actively preparing for pregnancy. However, women over the age of 35 are at increased risk after pregnancy. Older women want to have three children, how to "have a good child"? Baoyi invited experts from the prenatal diagnosis center of the Third Affiliated Hospital of Zhengzhou University (Provincial Maternal and Child Health Hospital and Provincial Women and Children Hospital) to help. Pre-pregnancy assessment, the prenatal and postnatal care plan for elderly pregnant women should be scientifically prepared, the health status should be evaluated, and a systematic and comprehensive pre-pregnancy examination should be conducted. 1. Evaluate past history, birth history and family history. Whether there have been repeated abortions, stillbirths, stillbirths, neonatal deaths, birth defects, etc. In the past, and whether there is a family hereditary disease or a birth history of children with hereditary diseases. In case of the above situation, you should receive relevant genetic eugenics consultation. 2. Evaluate the basic situation of the body and make it clear whether it is a pregnancy taboo. Body fat index (BMI) was evaluated before pregnancy, and blood sugar, blood pressure, thyroid function, liver and kidney function were examined. For example, elderly women with hypertension and heart disease should be examined and evaluated, and elderly women with immune system diseases should be examined for relevant immune antibodies. 3. Pre-pregnancy examination. Check six sex hormones, TORCH, gynecological ultrasound, chromosome examination, gynecological routine examination, leucorrhea routine examination, mycoplasma and chlamydia, etc. And exclude gynecological diseases, sexually transmitted diseases and viral infections, and give treatment when necessary. Pregnant mothers with hypertension, diabetes, obesity, asthma and thyroid diseases should actively control and treat them. 2. Supplementing folic acid in advance: The older the pregnant mother, the higher the probability of fetal neural tube dysplasia. According to the risk assessment of folic acid metabolism, folic acid supplementation was started in the first three months of pregnancy (400-800? G/d) can reduce the incidence of fetal neural tube malformation. 3. Develop good living habits, quit smoking and drinking, and work and rest regularly; Balanced diet, pay attention to nutrition; Keep a good mood and exercise properly. 4. Avoid contact with toxic and harmful substances. Prenatal diagnosis, a successful breakthrough 1. Early progesterone and color Doppler ultrasound examination. Early exclusion of ectopic pregnancy; Pay attention to the occurrence of fetal arrest or spontaneous abortion and pregnancy again after cesarean section, and pay attention to the implantation position of fertilized eggs; Pay attention to symptoms such as vaginal bleeding and abdominal pain, find abnormalities early and intervene in time. 2. Strictly carry out prenatal screening and prenatal diagnosis. The second trimester of pregnancy is an important period for screening fetal chromosomal abnormalities and structural abnormalities. The incidence of fetal chromosomal abnormalities is closely related to the age of pregnant mothers, and appropriate examinations should be selected according to the doctor's advice. ①NT examination: NT ultrasound examination (B-ultrasound examination of the thickness of the transparent layer behind the neck of the fetus) should be performed at113+6 weeks of pregnancy to assess the risk of fetal chromosome abnormality. ② Prenatal diagnosis: Pregnant mothers in the second trimester should choose Down's screening (15-20+6 weeks), noninvasive DNA (12 weeks) or invasive prenatal diagnosis according to their own conditions. For elderly pregnant mothers, invasive prenatal diagnosis should be the first choice because of the increased risk of fetal chromosomal abnormalities. ③ Fetal four-dimensional ultrasound examination (20-24 weeks of pregnancy) and fetal echocardiography examination (24-28 weeks of pregnancy) exclude fetal structural abnormalities and understand fetal development. 3. Pay attention to monitoring blood pressure and blood sugar. After 24 weeks of pregnancy, oral glucose tolerance test (OGTT) should be carried out as soon as possible for early diagnosis and treatment of gestational diabetes. 4. Small ovulation test in the middle and late pregnancy (28-32 weeks of pregnancy); After 28 weeks, fetal movements were strictly counted and fetal heart monitoring was carried out. When necessary, the length of cervical canal was evaluated by color Doppler ultrasound; Pregnant women with a history of cesarean section should check the thickness of uterine scar. 5. You should have regular check-ups throughout pregnancy. Monitor blood pressure, blood sugar, thyroid function and cardiac function, be alert to pregnancy complications, and make prenatal evaluation in obstetric clinic during perinatal period. Compared with school-age pregnancy, late pregnancy should be well prepared before and during pregnancy, pay attention to prenatal diagnosis, actively prevent or treat pregnancy complications and complications, maintain a good attitude and welcome a good pregnancy!