According to the CDC, there has been a continued upward trend in the mean age of pregnant women in the US. This is also being seen globally. Women, age 35 years and older are at higher risk for adverse pregnancy outcomes. Are growth ultrasounds recommended in the third trimester in this population? Are congenital anomalies more frequent? And at what age is antepartum surveillance recommended? In this episode, we will review the ACOG Obstetric Care Consensus # 11 from August 2022, which is also on the ABOG MOC article distribution list from February 2023, and answer these questions and more.