The Importance of Screening Tests and Amniocentesis in Approach to Pregnant Women Over the Age of Thirty-Five.

Objective: Our goal was to evaluate the approach to the increased risk of fetal chromosomal anomaly in pregnant women over thirty-five years of age. Methods: We retrospectively examined pregnant women over the age of 35 who underwent interventional procedures for fetal karyotype analysis in the Perinatology Clinic of University of Health Sciences Turkey Kanuni Sultan Süleyman Training and Research Hospital. Regardless of the indication for karyotype analysis, pregnant women over the age of 35 who underwent karyotype analysis were included in the study. Results: Abnormal karyotype was detected in 76 (8.7%) of a total of 867 pregnant women examined in the study. Of 76 abnormal karyotypes, 51 were found as trisomy 21 (67.7%), 15 as trisomy 18 (21%), and 3 as trisomy 13 (4%). Three fetal karyotype analyzes revealed Turner syndrome (4%), 1 Klinefelter syndrome (1.3%), 2 mosaic trisomy 21 (2.6%) and 1 mosaic Turner syndrome (1.3%). In the patients who underwent interventional procedures primarily because of advanced maternal age, abnormal karyotype was detected in 6 (1.9%) of them. The rates of abnormal karyotype results for double, triple and quadruple tests were 6.4%, 1.9% and 5.8%, respectively. Conclusion: The use of a triple test has no definite impact on the results of pregnant women of older age. When there is no fetal abnormality in the ultrasound, double and quadruple tests may be requested or since the fetal death rate is minimal in amniocentesis, it can be recommended directly without performing any screening tests in pregnant women with older age. [ABSTRACT FROM AUTHOR]