What to Do Before Conception

Gebelik planlarken düşünülmesi ve yapılması gerekenler

Preconception care, what to think and do when planning a pregnancy;
If the pregnancy is not a surprise and the pregnancy is being prepared for in a planned manner, you should first consult your family doctor for a consultation or be examined by an obstetrician-gynecologist.

The family doctor or obstetrician will ask questions about current eating habits, lifestyle, medical history of the expectant mother and her family, medications and past pregnancies and assess their impact on the intended pregnancy.

If there is no problem in the annual gynecological examination and the menstrual cycle is regular, you can also consult your family doctor. Here, routine blood tests are checked, hepatitis B, C, HIV, syphilis (syphilis) screening is performed. If the time has come, HPV screening is performed for screening purposes (screening to prevent cervical cancer before it occurs). However, if you have not been examined by an obstetrician in the last 1 year, it is useful to have a gynecologist’s examination.

During the gynecological examination, a vaginal examination is performed with a speculum. If the time has come, smear, hpv screening is performed. If there is an infection, treatment is organized. The uterus and ovaries are observed with ultrasonography. It is checked whether there are any gynecological conditions that may interfere with pregnancy.

Folic acid should be started daily 2-3 months before pregnancy is planned and continued throughout the first trimester of pregnancy. Folic acid will reduce the incidence of neural tube defects, which occur in approximately 0.9 per 1000 live births, by 72%. Neural tube defects are structural malformations of the baby’s brain, spinal cord or spine (such as anencephaly, spina bifida)

Since flu during pregnancy can be very dangerous, the Ministry of Health recommends flu vaccination for all pregnant women before conception and if not already done.

If the diet is fast-food based or uniform, a healthy and balanced diet should be adopted.

Being overweight during pregnancy is associated with many pregnancy and childbirth complications, including high blood pressure, pre-eclampsia, preterm labor and gestational diabetes (gestational diabetes). Obesity in pregnancy can also cause macrosomia, which means that the baby is too big, and macrosomia can lead to increased birth injuries in normal labor and the need for emergency cesarean section. Obesity also increases the risk of neural tube defects.
If the expectant mother is overweight, it can make it difficult to see the baby on ultrasound and hear the heartbeat during the obstetrician’s examination.

Being underweight before and during pregnancy also has risks. Women who are extremely underweight have an increased risk of giving birth to low birth weight babies. These babies may have some problems during birth, as well as health problems and behavioral problems in childhood and adulthood. Those who are underweight during pregnancy are also at increased risk of preterm labor.

Iron is also very important for pregnancy. It is important to provide extra blood support to carry oxygen to the pregnancy. Not taking iron supplements during pregnancy or starting pregnancy with iron deficiency may cause problems in some women.

Lifestyle should also be reviewed before pregnancy. Smoking, drinking alcohol or taking drugs can have a harmful effect on the fetus. Since the first trimester of pregnancy is the period when the baby is most vulnerable to external factors, completely eliminating harmful habits before pregnancy will reduce or even prevent the risk of some birth defects that may occur in early pregnancy.

Before considering pregnancy, it is also important to find out whether you have been exposed to any external factors at work or in the environment where you live. You should be asked about your environmental exposure to heavy metals such as lead or mercury, chemicals such as pesticides or solvents, or radiation.

You should also consider other health problems when considering pregnancy. Your family physician will already question you, but in people with diseases such as hypertension, diabetes, depression or epilepsy, the disease should be completely controlled before pregnancy begins and the pregnancy should be followed up with a multidisciplinary approach (together with the relevant branch). Medical treatments that may be harmful for the baby should be discontinued and non-teratogenic options should be switched to, and the risks of pregnancy should be decided together by the doctor and the patient according to the benefit-harm ratio.

Non-drug supplements called herbal supplements and folic acid, including all vitamins, should be used in consultation with your doctor before starting pregnancy, and no medication should be used without a doctor’s control and without a home prescription.

Infections can harm both the mother and the baby. Some infections can cause birth defects and certain diseases in the baby. Sexually transmitted diseases are also harmful during pregnancy, some of them can even prevent you from conceiving and can have harmful effects on the baby once you are pregnant. If such a disease is suspected in one or both partners, concomitant treatment should be carried out before pregnancy.

Of course, vaccination before pregnancy can be considered to prevent some infections because some vaccines are not safe during pregnancy. For example, if you are immune to rubella, you can be vaccinated, but you should not get pregnant for 3 months after vaccination. The flu vaccine can be administered before and during pregnancy.

Some pregnancy problems can increase the risk of having the same problem in the following pregnancy, but this does not mean that it will definitely happen. Problems that increase the risk of occurring in the next pregnancy are premature birth, high blood pressure of pregnancy, pre-eclampsia and gestational diabetes. Especially when you are aware of your increased risk before pregnancy, the pregnancy will be more controlled and the risks will be reduced.

Genetic counseling should be obtained before pregnancy, especially if the spouse is related to a consanguineous marriage or if there are some genetic diseases in the family.

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