Comprehensive Obstetric Services

Congratulations on your pregnancy! Pregnancy will be an exciting time for you, filled with new experiences and challenges. Dr.Daum and his staff are very experienced and have delivered thousands of healthy babies. We offer personalized and compassionate obstetric care. Our staff looks forward to guiding you through the joys of pregnancy and childbirth, answering your questions and partnering with you to achieve a healthy pregnancy and successful delivery. We care about what matters most: a healthy mom and a healthy baby.

Pregnancy After 35

Pregnancy after 35 can pose some special concerns. If your health is good, you should be able to have a successful pregnancy. More common problems that may develop such as diabetes and hypertension can be managed medically.

The specific age related issues are related to increased risk of chromosomal birth defects. The risk of trisomies (three chromosomes instead of two) is increased for chromosomes 13,18 and 21. Down syndrome is trisomy of chromosome 21. The increased risk is gradual with increasing age, but becomes progressively greater after age 35. 

The approximate risk at age 35 is 1/270, at 40 is 1/100 and at 44 is approximately 1/30. The risk of trisomy 13 and 18 is also increased, but as these birth defects are commonly lethal, they are less well known. Please see the other sections on dectection of chomosomal problems before birth.

When there are medical problems complicating pregnancy, consultants in other fields such as cardiology or endocrinology as well as maternal fetal medicine can be brought in as a team approach.

Keeping yourself fit and dealing with medical issues before conception can be critical to a good outcome. When early delivery is necessary, we have a great nursery to deal with the needs of your baby. Our level III nursery is staffed by the Neonatologists from Cook Childrens Hospital. If transfer of your baby should be necessary continuity of care is smooth and well coordinated within the same group of pediatricians.

Pregnancy after 35 is very common today, Have faith that you and your baby will be well!

Sequential Screen and MaternaiT21 screen
NSL stands for Nuchal SonoLucency. This prenatal screening test (also called the nuchal fold scan) uses ultrasound to measure the clear ("translucent") space in the tissue at the back of your developing baby's neck, and is combined with measurement of two hormones in mom's blood. That measurement can help assess your baby's risk for Down syndrome (DS) and other chromosomal abnormalities as well as major congenital heart problems. When combined with the Quad screen at 16 weeks you have the SEQUENTIAL SCREEN, which is the best of the noninvasive screens for down syndrome, trisomy 13, trisomy 18, and spina bifida.

Babies with abnormalities tend to accumulate more fluid at the back of their neck during the first trimester, causing this clear space to be larger. While the Nuchal SonoLucency screening test won't give you the definite diagnosis you'd get from more invasive tests like CVS and amniocentesis, it can help you decide whether you want to undergo MaternaiT21 blood testing or amniocentesis. Only the amniocentesis or CVS placental sampling can be considered "diagnostic".

The Nuchal SonoLucency screening must be done when you're between 11 and 14 weeks pregnant. (The last day you can have it done is the day you turn 13 weeks and 6 days pregnant.)

The sonographer first confirms your baby's gestational age by measuring your baby from crown to rump to see if he's about the size he should be for his age. The sonographer positions the sensor, called the transducer, over your abdomen so that your baby's nuchal fold area shows up on the monitor, and measures the thickness of it on the screen with calipers. Measurement of two pregnancy hormnes is performed, and these three values are used to calculate your baby's risk of Down syndrome and trisomy 18. Trisomy 18 is like Down syndrome, but in most cases is a lethal condition.

NSL testing should be performed only by certified sonography specialists.  Call us and schedule an appointment if you desire a screening evaluation.

If your initial results for trisomy come back higher than normal risk, there is a new test that measures free fetal DNA in the mothers blood. There are several names for the test but one of the most common is MaternaiT21 Plus Screen also offerred as "Harmony" maternal testing.This screen will diagnose 99% of downs syndrome, 99.9% of trisomy18, and 91.7% of trisomy 13. This test is available through the hospital and is called "NIPT". This test is not recommended for low risk individuals, but can be offerred to to all, with abnormal ultrasound findings, prior pregnancy with a baby with trisomy, positive screening test for chromosomal trisomy (sequential, quadscreen, or integrated screen.) All of these services can be offerred through our office.

If you need Comprehensive Obstetric Services contact Mansfield Miracles, Paul Daum, MD today at (817) 477-0200

Patient Education

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American College of ObGYN Patient Information Website

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