Study on the strategy of pregnancy preparation for older women
Zhang Wen Jing
(Beijing Military General Hospital, Beijing 100700)
Abstract: with the development of the society and the change of the concept of childbearing, the number of old pregnant women in China is increasing day by day. Since the implementation of the "two child" birth policy in China, many women have joined the second child birth army, resulting in an increase in the number of elderly pregnant women. The main risk factors of pregnancy are difficult pregnancy, easy abortion, pregnancy complications, more birth defects and high risk of bleeding. Moreover, it is difficult for the older parturient to get pregnant because of the decrease of egg quality, psychological pressure, excessive weight loss and bad living habits. In order to ensure the success rate of older women and the health of their mothers and fetuses, we suggest that women pay special attention to routine examination, adjust their hormones, abandon their bad emotions, maintain their standard weight, stay away from adverse environment and adhere to proper exercise.
Key words: older pregnant women; pregnancy preparation; strategies
1. Current situation of older pregnant women
Older pregnant women, also known as "older pregnant women", refer to those who are over 34 years old at the time of their first pregnancy or conception. With the development of the society and the change of the concept of childbearing, the number of old pregnant women is increasing. There are many reasons for the increase of old pregnant women year by year, among which the most important are social factors, such as the promotion of late marriage and late childbearing, the increase of social pressure, etc. In addition, the change of people's conception of procreation and the development of medical technology also result in the increase of gestational age year by year. In recent years, since the full implementation of the "two child" birth policy, many women have joined the birth army of two children, which results in many women being over 35 years old when they have a second child.
2 risk of pregnancy in older women
2.1 pregnancy is hard
Women over the age of 35 will begin to have fewer pregnancies, with a cumulative one-year pregnancy rate of about 75%. So, if a woman over 35 wants to be pregnant and still hasn't been pregnant after six months of active attempts, she should consult a reproductive doctor.
Women over 40 years old will have a sharp decline in their ability to conceive, with a cumulative pregnancy rate of about 40% - 50% in one year. Women of this age, even IVF, have a pregnancy rate of only 10% at a time. This is due to a significant reduction in the number of normal oocytes in the ovaries of women over 40 years of age. Therefore, women over 40 who want to be pregnant should seek the help of reproductive doctors if they are not pregnant after three months of trying.
For women over 45, pregnancy is a very difficult thing. The chance of conception is less than 1%.
2.2 abortion is easy.
In the whole population, the abortion rate is about 15%. With the increase of age, the abortion rate increases gradually. The abortion rate is about 25% at the age of 35, 35% at the age of 40, and 50% - 60% at the age of 45. The most important reason for the abortion of older pregnancy is the chromosomal abnormality of embryo.
2.3 pregnancy complications
Many elderly women may have mild diabetes or high blood pressure, which may not be detected at ordinary times. Once pregnant, the changes of various functions and hormone levels of the body will induce these hidden diseases, which will not only affect the normal development of the fetus, but also bring life risks to pregnant women. The common complications of elderly women are pregnancy hypertension, pregnancy poisoning, diabetes and so on.
2.4 many birth defects
With the increase of women's age, the quality of eggs is also declining, the probability of the problem of fertilized eggs is also increasing, and the incidence of abnormal children is increasing.
2.5 high risk of major bleeding
It has many advantages, such as small damage, fast recovery and so on. The risk of massive bleeding is much lower in women who have a second child than in women who have a first cesarean section. The major bleeding risks mentioned here are mainly for women whose first birth is cesarean section.
2.6 high psychological pressure
The elderly women care too much about the hard-earned experience of childbirth, but also worry too much about the accidents due to their old age. Especially in the stage of labor, the whole family is under great psychological pressure.
2.7 facing severe parenting and education problems
The elderly women are not as energetic and physical as the young women, and it is very difficult for the elderly at this time to have the energy to help share some responsibilities of raising children, which is the problem that the elderly women must face.
The reasons for the difficulty of pregnancy of the old parturient
3.1 egg quality decline
Older women's eggs are susceptible to contamination. With the increase of age, women's eggs will continue to be polluted and affected by the environment. Therefore, the later the time of pregnancy and delivery, the greater the impact of environmental pollution on the egg, the lower the quality and activity of the egg cells, the lower the fertility, and the chromosomal abnormality of the egg, leading to birth defects or abortion.
3.2 poor sperm quality
It is difficult for a woman to conceive, and her partner has an unshirkable responsibility. New research shows that if a husband's childbearing age is too old, it can also cause his wife to miscarry. Its age is basically 35 years old. The older the sperm is, the more abnormal genes it contains, and the lower its quality.
3.3 high psychological pressure
In addition to the physiological reasons, the elderly women also bear the pressure from family, society and other aspects, which will lead to the loss of the opportunity to be a mother for some women who could have their own children.
3.4 over weight loss
In order to lose weight quickly, women will take large doses of drugs, and some women will go on excessive diet for reducing weight children, which is easy to have adverse effects on the central nervous system and endocrine system, resulting in decreased secretion of estrogen and progesterone, menstrual cycle disorder, decreased menstrual volume and other symptoms, resulting in ovulation disorders and infertility.
3.5 bad habits
Among the bad habits, long-term smoking and drinking are the most influential. The study found that women smoking can interfere with and destroy normal ovarian function, cause menstruation disorder, premature menopause and infertility. Even if pregnant, smoking women are prone to miscarriage, premature delivery and stillbirth. The weight of their children is much lighter than that of non-smokers. Women who drink too much or drink too much will cause ovarian atrophy, irregular menstruation and infertility.
Suggestions on pregnancy preparation for 4-year-old women
4.1 pay special attention to routine inspection
The doctor will judge whether the woman has the basic conditions for conception according to the following tests:
4.1.1 endocrine examination related to female reproductive function:
Women need to draw blood within the 72nd hour after menstruation to understand the hormone levels related to female reproduction, such as pituitary hormone, ovarian hormone, thyroid hormone, etc.
4.1.2 examination of follicular growth of female party:
On the 12th-14th day of the menstrual cycle (when the menstrual cycle is normal), the growth of the follicle was detected by B-ultrasound: the maximum diameter of the follicle, whether the egg was excluded, and the thickness of the endometrium on the ovulation day.
4.1.3 check whether the female fallopian tube is unobstructed and the degree of obstruction.
2-7 days after menstruation, salpingostomy should be performed. If there is a possibility of obstruction, X-ray lipiodography or ultrasound should be performed to identify the position of the obstruction. In severe cases, hysteroscopy and laparoscopy should be used to understand the endometrial and fallopian tube conditions in a more comprehensive way. At the same time, corresponding operations should be carried out to correct or repair the lesions (abstinence is required before operation). )
4.1.4 examination of immune infertility and its causes:
Blood was drawn for the detection of related antibodies.
4.2 regulate normal hormone secretion
In order to get pregnant smoothly, the elderly women need to adjust their menstruation. Regulating menstruation refers to adjusting menstruation, making menstruation time regular, menstrual period suitable and menstrual volume normal. Belt management refers to the regulation of vaginal secretions, too much secretion is the performance of wet body, which will cause infertility, too little will cause vaginal dryness, difficult to walk, and affect pregnancy. It is suggested to turn to the old Chinese medicine for treatment, or take peiovalbumin under the guidance of a doctor. It can remove toxins in the body, promote the increase of adrenals and oestrogens, supplement nutrients and energy necessary for the growth of eggs, enhance the body's immunity and vitality, improve the environment of intrauterine pregnancy, and effectively improve the probability of pregnancy.
4.3 abandon bad mood
Bad emotions such as agitation, anxiety, and chagrin unconsciously affect the fertility of women. Women often have mood swings, which easily lead to hormone changes in the body, abnormal menstruation, endocrine disorders and other symptoms, which in turn lead to heavy psychological pressure, sensitivity to interpersonal relationships, anxiety, depression, paranoia. In the long run, the ability to conceive will become low, and even lead to infertility. When preparing for pregnancy, the elderly women should have a sexual life full of pregnancy mission under the condition of pleasant mood, no depression and worry; depression is not conducive to the physical development and emotional intelligence development of the fetus.
4.4 maintain standard weight
Too fat or too thin will affect the secretion function of the body, which is harmful to pregnancy, and even increase the risk of upper respiratory disease and diarrhea after birth. Women are too thin, fat is not enough normal number, there will be endocrine disorders, not easy to pregnancy. Data show that 6% of infertility patients are caused by underweight. In addition, women who are too bony are prone to malnutrition. The endometrium is like a barren soil, and the fertilized eggs are difficult to be implanted. It's also hard for a woman to conceive if she's too fat, even if there are risks. Obesity of expectant mothers will lead to the increase of pregnancy complications, such as pregnancy hypertension, the prevalence of which is 50%; gestational diabetes, obesity of expectant mothers, the prevalence of this disease is 4 times higher than that of general expectant mothers. In addition, obesity greatly increases the possibility of abortion, dystocia and stillbirth of expectant mothers, and the mortality of newborns is significantly higher than that of normal weight newborns.
4.5 keep away from adverse environment
During pregnancy, the elderly women should avoid all kinds of environmental pollution, such as high temperature, ion radiation, electromagnetic field, microwave radiation, pesticides, etc. We should try our best to reduce the use of microwave ovens, cordless telephones, vacuum cleaners, electric blankets, hair dryers, mobile phones and other household appliances with serious electromagnetic radiation. Women working on computers are advised to go outside every hour or turn off computers when they are not needed to reduce the harm of computers. At the same time, minimize makeup, avoid hair coloring, nail polish and so on.
4.6 keep moderate exercise
Exercise is not only limited to the gym, outdoor aerobic exercise at any time and anywhere is more conducive to the maintenance and improvement of women's fertility. Fast walking, jogging, swimming and yoga are the best sports to improve the flexibility of the body, enhance the sense of balance, and massage the internal organs of the body. In addition to maintaining vitality, it is more important to strengthen immunity and reduce the incidence of disease.
4.7 refuse to smoke and drink
Cigarettes contain many harmful ingredients such as nicotine, whose toxicity can directly affect the eggs, so that women enter menopause early, long-term smoking will also affect the ovarian function. Excessive drinking may endanger the function of reproductive system and lead to endocrine disorder. Long term drinking will also hinder the development and maturity of eggs, which will easily lead to the increase of infertility and malformed babies. Drunk pregnancy can also cause fetal growth retardation, mental retardation.
4.8 cultivate a mild uterine environment
The elderly pregnant women need to cultivate a mild uterine environment, away from the cold and gynecological diseases. Palace cold refers to the cold syndrome of female uterus in traditional Chinese medicine. The physical manifestations of uterine cold are dysmenorrhea and irregular menstruation; the temperature of the uterus is low, which is not suitable for the growth of the fetus, even if pregnant, it is easy to miscarry. Women who have a cold palace should eat more warm food, such as walnuts, dates, peanuts and so on.
4.9 supplement necessary special medical food
In addition to strengthening nutrition and paying attention to the balance of diet, it is necessary for the elderly women to supplement targeted special medical food during pregnancy preparation. There are more than 20 kinds of nutrients and microelements necessary for the growth of eggs in the egg culture developed by Harvey life science group. Under the premise of supplementing nutrition, energy and maintaining normal weight, it can effectively promote the increase of adrenals and oestrogen, remove toxins in the body, improve the environment of intrauterine pregnancy, and thus effectively improve the probability of pregnancy. The clinical experiment shows that peiovalbumin has a very good auxiliary effect in the treatment of female infertility and the success rate of in vitro baby, and can effectively reduce the incidence of birth defects.
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