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Doctor-patient conversations about health risks require good communication. Date published: 7/4/2010
IGRADUATED from medical school 10 years ago, and since then I have had precious few opportunities to be So when I recently learned that my wife is pregnant (due in October), I did not anticipate that accompanying her to obstetrical appointments would change my understanding of the doctor-patient relationship in a profound way. The pregnancy has been healthy and again, However, due to the fact that my wife celebrated her 35th birthday last week (Happy birthday, honey!) we were encouraged by our well-meaning obstetrician to see a perinatologist as well. Perinatologists are also known as maternal-fetal medicine specialists, and are sometimes more aptly referred to These specialists care for pregnant patients with complicated pregnancies--gestational diabetes, unborn children with congenital defects, and other chronic health problems that women may have prior to pregnancy or may develop during pregnancy. "But wait " I can hear the average reader's double-take: I thought your wife and the pregnancy were healthy? Why see a high-risk doctor? It turns out that it's all about how to evaluate risk. FEAR FACTOR The American College of Obstetrics and Gynecology has long held the position that once a woman passes the magical age of 35, she should be considered of "advanced maternal age" if she chooses to become pregnant. (Good thing ACOG didn't use the terminology "pretty darn old to have a child.") Most of this arbitrary distinction comes from the risk of having a child with Down syndrome, also known as trisomy 21, in which a child is conceived with three copies of chromosome No. 21 instead of two copies. The extra copy of chromosome 21 causes a number of potential conditions such as heart defects and lower IQ. At the age of 25, a woman has a 1-in-1,250 chance of having a child with Down syndrome. At 35, that risk rises to 1-in-400, and by 49, that risk escalates to 1 in every 10 children born.
Date published: 7/4/2010
1. Be respectful. No personal attacks.
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