O&G Cases · Antenatal care — maternal age and ART
Booking visit for a 41-year-old ICSI singleton — communication and planning station
Communication and planning station: the booking visit for an advanced-maternal-age ART-conceived singleton. Tests the candidate's ability to distinguish age, subfertility and ART risk contributions; design a risk-tailored surveillance plan; counsel on congenital anomalies and imprinting disorders using the Davies NEJM and Lazaraviciute evidence; address the timing-of-birth conversation with the Reddy stillbirth data; and communicate with the frightened older ART mother. Includes assessor key and marking domains.
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Target exams
Station brief
Format. Communication and planning station, approximately 12 minutes. You are the obstetric registrar in the antenatal clinic. The woman is with her partner. The assessor plays the woman and feeds you her questions.[1]
Candidate instruction. Conduct the booking visit for this advanced-maternal-age ART-conceived singleton. Distinguish the three risk contributions, design a risk-tailored surveillance plan, counsel on congenital anomalies and imprinting disorders, address the timing-of-birth conversation, and communicate with the frightened woman who has waited seven years for this pregnancy. Verbalise your reasoning as you go.[1][5]
You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Obstetrics & Gynaecology fellowship atlas.
References6Show ledgerHide ledger
- [1]Reddy UM, Ko CW, Willinger M Maternal age and the risk of stillbirth throughout pregnancy in the United States Am J Obstet Gynecol, 2006.PMID 16949411
- [2]Davies MJ, Moore VM, Willson KJ, et al. Reproductive technologies and the risk of birth defects N Engl J Med, 2012.PMID 22559061
- [3]Pandey S, Shetty A, Hamilton M, et al. Obstetric and perinatal outcomes in singleton pregnancies resulting from IVF/ICSI: a systematic review and meta-analysis Hum Reprod Update, 2012.PMID 22611174
- [4]Lazaraviciute G, Kauser M, Bhattacharya S, et al. A systematic review and meta-analysis of DNA methylation levels and imprinting disorders in children conceived by IVF/ICSI compared with children conceived spontaneously Hum Reprod Update, 2014.PMID 24961233
- [5]Luke B Pregnancy and birth outcomes in couples with infertility with and without assisted reproductive technology: with an emphasis on US population-based studies Am J Obstet Gynecol, 2017.PMID 28322775
- [6]Zhang H, Wang W Risk factors and adverse pregnancy outcomes in older pregnant women with hypertensive disorders of pregnancy J Obstet Gynaecol Res, 2022.PMID 35596590