Maternity Care Over 40 & Screenings

[calishire]

I searched for previous threads but couldn't find anything... I'm 40 and just found out (completely unplanned!) that I'm 5 weeks pregnant. I have one DS who just turned 6. I'll be 41 when I give birth if it all goes to plan. I was just wondering if the NHS treat the pregnancy as high risk due to advanced maternal age automatically or if they look a different factors. I wasn't sure if they would do a scan earlier than the norm or just what to expect in general.

We definitely want to have a private NIPT test, but my head is all over the place as it seems there are lot of different options. At over 40, is it pretty much guaranteed you would get a high risk result on the combined screening at 12 weeks?

We have 1 healthy child, had two previous miscarriages and no other risk factors that I can think of apart from age and being overweight (BMI of 28ish).

Congratulations.

Neither your age nor your BMI would put you on a different care path in themselves. The first scan is offered around 11-14 weeks.

The testing may come back with a risk factor that's in the hundreds rather than tens of thousands because of your age but if you intend to do a private NIPT you'll get a definite answer.

Best of luck.

Hi @calishire I had my baby at 41 yrs old. My doctor put me on low dose asprin. It was to prevent preeclampsia. I got offered alot of the norm tests. My midwife didn't think anything of my age, she said it's really common for women to have children later on in life.
Congratulations on your pregnancy, yay! Xx

i had all of my three when i was over 40 (40, 41 and 43). each time, i was automatically put under consultant care due to age (but reality was that meant i have two 5min meetings with a consultant as i wasn't high risk in any other area). First two times, the NHS combined test came back low risk, and confirmed by private NIPT. Third time, combined blood test said 1 in 26 chance of Downs, and i was offered NIPT on the NHS, and it came back low risk.

in terms of screenings, offered all the usual tests and additional scans from 28 weeks. the first two times it was every three weeks from 28weeks and the third (in 2021) the policy had changed to every 6wks from 28 weeks. Also third time around, i was prescribed 75mg asprin, but that was due to a policy change, not age.

Interesting stuff. I wonder if it varies by Trust.

@calishire advice is now 150mg of aspirin every evening. I am 42 and 15 weeks pregnant. I went for this at 9 weeks. Results were back in a few days.

When I had my 12 weeks scan they did the measurement of the nuchal fold anyway and took my bloods. Results came back after about 9 days.

Was glad I did it privately instead of waiting x

I was 40 when I conceived and had my second DC. I was low risk and midwife led and my combined test was low risk, but in the hundreddrather than 000s or 0000s

Sorry that was supposed to say hundreds rather than thousands or tens of thousands

I think if you're over 40 you are automatically consultant led as it's a geriatric pregnancy. I was pregnant at 40 and gave birth at 41. My age was the only factor (weight ok, no medical issues, had a previous straightforward pregnancy) so I had little contact with the consultant. My combined screening result at 12 weeks came back high risk of Downs Syndrome so I had NIPT on the NHS. It was recommended not to go over 40 weeks due to the risk of the placenta starting to fail so I was induced at 40 + 1. Happy to answer any questions if I can

It clearly differs by trust as I was told they no longer induce at 40 weeks because of age. They consider it on a case by case basis with regard to all risk factors

Same x

I guess I'll find out soon enough how my trust do things. I had a look at the advice on taking aspirin and I don't think i meet the criteria... Really hope this sticks. Totally unplanned but actually surprisingly excited about it all. I've previously had two miscarriages though so just feeling very cautious about it all.

Hi, it does vary trust to trust. When I had my first appointment I was told I would be consultant led due to age...41 and IVF. Then by 20 weeks the trust decided that they no longer consider age or IVF as high risk because its so common. However the trust in the neighbouring area still does consider age high risk as I attended a local antenatal course recently and a number were under consultant led care. X

@SPR40 that's strange. Sounds more like it's so common they don't have the resources to be consultant led!

@calishire yep that's what we thought too. It really threw me for months and caused a lot of worrying because noone told me until I was chasing my consultant appointment as it hadn't come through. There was a note on my file saying not needed but no reasons why, took another few weeks for them to confirm.

Just to add we had NIPT private before our NHS tests so that we already had the result in advance (I have history of NHS delivering new shockingly so would rather know myself first). My NIPT risk was low, NHS high they offered NIPT but we had already had it.

Congratulations on your pregnancy 🥳✨️

I'm 42, ivf and consultant led x