High-Risk Pregnancy: 11% of Women Giving Birth in Alicante Are Over Forty

Delaying motherhood is a social reality gaining ground. Experts estimate that at 35, women experience a reduction in the quantity and quality of their eggs, which "increases the risk of chromosomal abnormalities and miscarriages," explains Dr. José Manuel Lozano, head of the Gynaecology Service at the Vithas Medimar Hospital in Alicante.

This healthcare group provides another figure to illustrate the magnitude of this phenomenon: 11% of women are now over 40, which is considered a high-risk pregnancy.

"The increase in life expectancy by more than 30 years in the last century has shown us that many organs withstand the greater wear and tear of time well. However, this is not the case with ovaries, which have not improved with better living conditions, medical advances, or nutrition," comments Dr. Virginia Prieto, head of the prenatal diagnosis unit at Vithas Medimar Hospital.

In this regard, the aim of prenatal diagnosis is to conduct all diagnostic tests aimed at identifying the presence of fetal congenital defects as well as maternal risk factors that require strict monitoring during pregnancy.

Regarding screening techniques, "we perform the combined ultrasound-biochemical screening of the first trimester, which allows us to identify between 85-90% of fetuses affected by a chromosomal abnormality. It consists of a combination of maternal age, ultrasound data (nuchal translucency), and biochemical data (free B-HCG, PAPP-A)."

Additionally, advanced screening is also performed through the detection of fetal DNA in maternal blood, which "allows us to detect the main fetal chromosomal abnormalities non-invasively, by determining a maternal blood sample from the 10th week of gestation. It offers high detection rates, close to 99%."

Lastly, the screening for preeclampsia risk, "which affects 2-8% of pregnancies, represents the leading cause of maternal mortality and poses a high risk of intrauterine growth restriction (IUGR), prematurity, and intrauterine death."

The screening is conducted through a DOPPLER ultrasound of the uterine arteries in the 12-14 week of gestation, biochemical measurements in maternal blood (PAPP-A and others), and the use of medical calculators that estimate the individual risk of developing preeclampsia during pregnancy.

Moreover, there are several invasive techniques to obtain and study fetal cells. The choice of the most suitable one depends on the personal circumstances of the pregnant woman, the stage of pregnancy when it is considered, and the type of congenital defect to be identified," explain the specialists.

Such as Chorionic Villus Sampling, an analysis of a sample of placental material obtained via transcervical or transabdominal route, and amniocentesis, an analysis of fetal cells present in the amniotic fluid obtained through abdominal puncture. Lastly, the ultrasound examination, "which is the basis of prenatal diagnosis."

Additionally, "in the event of suspicion or prenatal diagnosis of a possible congenital defect, we offer the possibility of multidisciplinary counselling with the collaboration of different specialists. We work with the genetics unit, the radiology service, and paediatrics," explains Dr. Lozano.