Preconception planning is essential for a healthy planned pregnancy and baby. “Should I take prenatal vitamins before I get pregnant”- many couples asked me this question. Adequate health checks must be ensured before getting pregnant. This post will walk you through some basic things to do before getting pregnant. A healthy mother is essential for healthy baby, thus a healthy nation. World Health Organisation puts emphasis on making sure a healthy mother for a healthy baby. Every couple should make the list of “the getting pregnant plan” so that nothing unplanned happens in the midway. Some medical diseases need special attention. As for example any past history of genetic disease, hormone problems, hypertension, diabetes mellitus etc. Tests Before Getting Pregnant varies among individuals. Follow this post to learn more.
A complete medical history, physical examination, and essential investigations are necessary for healthy pregnancy. Both physical and mental sound health is the prerequisite for a successful outcome of pregnancy. Socioeconomic status has a great value on mother’s health. Parents education regarding the common problems in pregnancy and events of pregnancy should be known to the mother. I will only talk about the medical aspects of getting pregnant and Tests Before Getting Pregnant.
Stop getting Pill: Sometimes taking the oral pill for a long time may delay the menstruation and hamper pregnancy. Stop taking the pill as soon as you and your partner are planning for pregnancy. It can take sometimes to get your hormone balance to become normal.
Quit Smoking and Alcohol: No doubt alcohol and cigarette smoking is pretty common in the western world, but not in Bangladesh. So if you have the habit of smoking, stop now for your own good. Smoking reduces the body weight of the baby. Smoking is also associated with an increased risk of miscarriage and stillbirth. The infant has a greater risk of sudden infant death syndrome (SIDS). Excess alcohol may cause “fetal alcohol syndrome” of the baby. Alcohol can also lower sperm count in men.
Pre-pregnancy Folic Acid Supplements: Folic acid is the single most important vitamin supplements for getting pregnant. According to CDC: The U. S. Public Health Service and CDC recommend that all women of childbearing age consume 0.4 mg (400 micrograms) of folic acid daily to prevent two common and serious birth defects, spina bifida and anencephaly.
CDC also recommends All women between 15 and 45 years of age should consume folic acid daily because half of U.S. pregnancies are unplanned and because these birth defects occur very early in pregnancy (3-4 weeks after conception) before most women know they are pregnant. Source CDC.
Gestational Diabetes mellitus: Diabetes that appear during pregnancy is called gestational diabetes mellitus. Care should be taken for diabetes. Insulin is prescribed to control diabetes during pregnancy. Oral diabetic drugs may cross the placenta and cause fetal hypoglycemia. So if you are on an oral diabetic drug before pregnancy consults with your doctor for switching to insulin if necessary. Also, uncontrolled diabetes causes fetal macrosomia or the big baby.
Taking Medications that may cause birth defects: There are some drugs that cause teratogens effects on the baby. They must be avoided during pregnancy. You don’t know them, so better not to take any drugs without doctors advice. As for example retinoids, ACE Inhibitor, warfarin, sodium valproate etc. Here is a list of potentially harmful drugs during pregnancy MedicineNet.com.
Prevent Congenital Infection: Avoid eating undercooked meat and wear gloves when handling cat litter can prevent exposure to toxoplasmosis. Listeria infection can be acquired from eating unpasteurized dairy products, soft ripened cheeses, e.g. brie, camembert and blue-veined varieties, patés and readytoeat poultry, unless thoroughly reheated. Eating liver during pregnancy is best avoided as it contains a high concentration of vitamin A. Source: Illustrated Textbook on pediatrics.
Past History of Medical Disease: Previous history of spontaneous miscarriage, abortion or preterm delivery needs special attention. The cause should be identified and treated. Genetic counseling should be done to parents if they are at increased risk of the inherited disorder.
Overweight: It is another bad problem. With the lifestyle of present days, it’s an alarming trend. Half of Women Overweight Before Getting Pregnant (Source)
Vitamins before getting pregnant: Yes, you should take prenatal vitamins before even getting pregnant. Commonly used vitamins are vitamin E, vitamin C and multi vitamins tablet, Zinc iron, calcium, copper etc. Here is a sample prescription for Bangladeshi couples planning for pregnancy:
Started when you are planning for conception: (start 3 months before getting pregnant)
Tab. E cap 400mg 0+0+1
Tab. Ceevit (Vitamin C) 250mg 0+0+1
Tab. Rex 0+0+1
Additional drugs after getting pregnant but not without consulting a doctor.
In the first trimester or first 3 months:
Tab. Folison 5mg 0+0+1
Tab. Aristovit B 0+0+1
After first trimester or 3 months of pregnancy onwards.
Cap. Ziliron 0+0+1
Tab. Calbo D 1+0+1 (after meal)
Calcium is necessary for bone formation. Many Bangladeshi women have iron deficiency anaemia, so iron is capsule is necessary. Remember, prenatal vitamins are a complement to a healthy diet — not a substitute for good nutrition.
Tests Before Getting Pregnant
Gift of the 21st century is the modern technology for antenatal diagnosis. A handful list of the screening test is available. All of them is not necessary for every couple. Your doctor will decide which one you should do.
1. If you had any history of unprotected sex before, you must go through these screening test.
- Hepatitis B: HbsAg
- Syphilis: VDRL
- Rubella: Anti-Rubella IgG and IgM
- HIV infection: Anti HIV (1+2)
2. Blood group: Negative blood group of the mother needs to take care of. See here for details:
After Delivery Care of Rh Negative Mother giving Birth to Rh +ve Baby
3. Serum Haemoglobin level: Low hemoglobin below (11 gm/dl) needs to take care of. If you have anemia, you must correct anemia. Do Peripheral blood film, Serum Iron Profile to detect hematological disorder like Thalassemia. Hb Electrophoresis may be needed if you had a family history of the congenital hemolytic disease.
4. Ultrasonography: 50–70% of major congenital malformations can be detected. If a significant abnormality is suspected, a more detailed scan by a specialist is indicated. Anomaly scan is done at 18th week. At least 3 USG should be done during the pregnancy period.
4. Some special tests not for everyone:
- TSH (checks thyroid)
- Fasting blood sugar and 2HAB to detect diabetes.
- Semen Analysis
- Hemoglobin Electrophoresis
- Urine Routine Examination
Tests Can be done after getting pregnant: Not routinely necessary
- Amniocentesis
- Fetal blood sampling
- Chorionic villus sampling
- Fetoscopy
Preconception check up cost: This varies from country to country. See here cost in Dhaka.
Available Investigations and Fees in BSMMU PG hospital [How To]
Dental Care During Pregnancy:
Sometimes dental hygiene is missed. Periodontal disease can harm your pregnancy nad baby. Here is everything about dental care during pregnancy: Dental Care & Pregnancy – Your Complete Guide
Addiction and Substance misuse or Alcohol is harmful for babies. See here (www.rehabcenter.net) for more information.
Essential Links and Source:
Planning your pregnancy www.nhs.uk
Additional Reading:
Planning A pregnancy (PDF) – FPA PDF
Prenatal screening and diagnostic tests PDF, especially for doctors and medical students
Pregnancy by www.womenshealth.gov PDF
The Pregnancy Book Your complete guide PDF, Informative.
That’s all for now. If you have any query let me know. I will answer them as soon as possible.
Thanks for visiting my site.
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