Pre Conceptional Counseling is the counseling in which a Gynaecologist guides the couple to plan a healthy pregnancy. This kind of counseling is normal in western culture but now it also comes to be popular in urban India. Still In India, couples visit the gynaecologists for the pre conceptional counseling when they have hit to a road block. Many complications in pregnancy are just due to unawareness in their daily life. For Example, Isotretinoin, a drug used to treat acne can make anomalies in baby and can lead to miscarriage. These sorts of medicines should be stopped at least 3 months before attempting to conceive.
The Importance of Pre Conceptional Counseling:
• It decreases low birth weight baby, pre maturity, pre term birth, maternal & fetal mortality.
• Risk Assessments of both the partners are done to prevent poor outcome of the pregnancy. Benefits of Pre conceptional counseling are to healthy mother & healthy baby through healthy pregnancy.
• It mainly involves Genetic Screening of both the partners to prevent spread of potentially hazardous hereditary diseases to the next generations.
• Blood & clinical examinations are important to rule out Diabetes, Hypertension, High Cholesterol, Thyroid abnormality, Sickle cell Anemia, Thalassemia, etc.
• Medicational History of any chronic or acute conditions is necessary to prevent teratogenicity.
• Ultrasound Examination of Abdomen & pelvis are done to see any pathology to Uterus, Ovaries, Kidney, Liver, Appendix, etc. Because Renal Stones, Fibroid uterus, Appendicitis are fatal during pregnancy & it can also leads to Miscarriages or poor pregnancy outcomes.
When a Couple should go to a Gynecologist for Pre Conceptional Counseling?
• Along with pre marital counseling.
• When a couple wants to become parents.
• When a couple faces infertility.
Aim of Pre Conceptional Care:
• High Risk Assessment of the Couples: High Risk Assessment of the Couples are done regarding any medical or surgical history, personal history, family history & previous bad obstetric history.
• Healthy Diet & Nutrition: Healthy diet & Nutrition are individualized for the couples. Minerals & vitamin supplements are advised which are essential before Pregnancy. Daily requirement of Folic Acid, Vitamin B12, Calcium, Iron, Omega 3, Vitamin D3 are specified. The Couples are advised to take healthy diet & get away from the unhealthy ones.
• Need of Vaccinations before Pregnancy: Vaccination is highly effective & easy way to keep a mother & baby healthy from some vaccine prevented diseases. During the time of Pregnancy, a mother shares everything with her baby. So it is better to get vaccinated before the pregnancy & even during the pregnancy (recommended vaccines only) to keep you & your baby safe & healthy. Hepatitis B, Rubella, MMR, Cervical cancer vaccines, influenza vaccine are some vaccines that a woman can take before pregnancy.
• Solving Individual issues coming in Pregnancy: Health Problems those are specific to some persons only like Hypertension, Diabetes, Thyroid, Epilepsy, Cardiac disease, Recurrent Pregnancy loss are to be monitored. Certain medicines those are helpful in above conditions are rechecked again, for teratogenicity & if found teratogenic, replace it & counsel the couple regarding this. In Chronic Hypertensive woman, if she is planning for pregnancy, her antihypertensive medicines are replaced with Labetolol or Nifedipine or alpha methyl dopa whichever suggested by Gynecologist. If you are prescribed Warfarin for your health condition, it should be replaced by heparin or your PTU drug of Hyperthyroidism should be replaced by carbimazole. If woman is suffering from any cardiac illness, genetic counseling of the couple is done for any congenital heart anomaly & also rules out conditions where pregnancy is contraindicated.
• Habitual Advise: Habitual advice to the couple regarding smoking & drinking habit is done. Alcohol drinking & Cigarette smoking both are injurious to maternal & fetal health.
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