Pregnancy after thirty and incompetent cervix

Patient

Q: I am 38 years old and have had 4 children. My first child at 19 my second at 21 my third at 30 and my fourth at thirty. I had incompetent cervix with my third and lost him at 24 weeks in to my pregnancy. I had the same thing with my fourth child and had a cerclage put in and delivered him at 36 weeks. When I was 35 I had a tummy tuck. My question is would it be possible to have another baby? Given my age , incompetent cervix and tummy tuck?

Doctor

A:   Although it is possible for you to have another baby, the risks outweigh the benefits. Women in their thirties may experience a decline in fertility, furthermore,complications during pregnancy are more common when women reach age 35. These problems may be due to a decrease in the number and health of the eggs to be ovulated, fewer number of eggs and changes in the hormones resulting in altered ovulation. Along with the incompetent cervix, the risk of giving birth to a child with a birth defect does increase as the mother's age increases. Women at the age of 35 and above are considered to be at high risk for chromosomal abnormalities. Approximately 1 in 1,400 babies born from women in their 20's have Down syndrome; it increases to about 1 in 100 babies born with Down syndrome from women in their 40s. Studies have also shown an increased risk of miscarriage as the age of the mother increases. I would recommend that you speak with your obstetrician regarding the risks to the baby due to advancing maternal age and incompetent cervix. Though no doctor can stop you from being pregnant, if you are planning to have a child, I would advise that you make regular appointments with your health-care provider, take prenatal vitamins (folic acid) a month before attempting to conceive, limit caffeine consumption, avoid alcohol and smoking. Along with all these tests, you may also be required to undergo appropriate genetic counseling, including a detailed discussion regarding the risks and benefits of the procedures. I hope the information helps, take care.

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