Friday, 27 May 2011

Before pregnancy (Prenatal): Preparing yourself for pregnancy

Q I am preparing to start a family. What are the things I need to know before I see my obstetrician?

You will want to know if you have had your vaccinations for rubella, hepatitis A and B, and flu. A family history of inherited disorders should be sought both on yours and your husband's side such as mental retardation, thalassaemia (an inherited blood disorder), down's syndrome or any chromosomal disorder. Past illnesses and operations should be noted and any treatment or medications for present illnesses recorded. Allergies to drugs should be known. You should also convery past gynaecological problems to your obstetrician.

Q I plan to get pregnant soon. Do I need to see an obstetrician for an examination and what can i
I expect at this examination?

Yes, it is advisable to see an obstetrician prior to your conceiving. He will want to take a medical, gynaecological and family history, perform a general examination including taking your blood pressure and testing your urine for sugar. He will also want to perform a gynaecological examination to exclude conditions such as endometriosis (blood cysts) or fibroids, both of which are common in women and can affect fertility. A pelvic ultrasound scan will detect these conditions. Having taken a history of your menstrual cycle he can then advise you on the best time to conceive. He will want to do certain blood tests and if necessary genetic counselling.

Q Does my husband need to have a medical check-up prior to my conceiving?

If your husband has a history of a genetic disorder, fathered a child with a birth defect, previously contracted a sexually transmitted disorder, had mumps or tuberculous infection (both of which can cause damage to the testicles and infertility) he should then go for a check-up.

Q How soon and how should I prepare myself for my pregnancy?

You should start preparing as early as 3 months before getting pregnant. Try and determine when you are ovulating. If your periods are regular, ovulation is 2 weeks before your next period. If your periods vary by a few days, an ovulation (LH) kit from the pharmacy can help you determine your date of ovulation. You should take a folic acid 5mg/day to prevent miscarriages and abnormalities. A general multivitamin and a well balanced diet should be consumed. Avoid high doses of multivitamins A and D as they can cause foetal abnormalities. If you smoke or drink, you should try to reduce or cut it out totally. If you are diabetic or hypertensive you will need to see your doctor to have these well controlled before pregnancy. Excercise moderately and if fit you can continue through into your pregnancy. Avoid gaining excessive weight or dieting, contact with chemicals, taking long distance flights during the months that you are trying to conceive.

Q I have been on oral contraceptives and now want to start a family. Do I have to wait after stopping before trying for a pregnancy?

If you have been on the OC for some time, it may take several months for your ovaries to start functioning properly. Once the periods become regular you have started ovulating and there is no reason not to start right away. There are no adverse effects on your pregnancy.

Q What foods should I consume in preparation for my pregnancy?

You will want to eat a healthy, sensible diet. If it is possible, go with organic food as much as possible. Eat lots of food rich in vitamins and fibre. Do eat fresh foods, vegetables and fruits. Avoid foods high in preservatives or unrefined carbohydrates. Oily fish and lean meats are best.

Q Do I need to do any excercise prior to conceiving?

Pregnancy is a stress on the body. For you to enjoy your pregnancy you should try to keep yourself fit. Start by doing excercises such as walking half an hour a day, swimming and cycling twice aweek. Your excercises may be carried on into your pregnancy. keep your muscles toned and joints supple with stretching excercises or yoga. Toning excercises should be aimed at your abdominal muscles, lower back and calf muscles. Avoid jogging or running.

Q Why do I need to keep myself fit before my pregnancy?

Excercise benefits are prevention of backache and improvement of posture and as a result less pain during the nine months of pregnancy. If you are fit and healthy, you are more likely to enjoy your pregnancy and suffer less from pain and depression. It may also help with recovery after your delivery. Start early and gradual rather than vigorous and late in the pregnancy.

Q What can I do to minimise the risk of birth defects in my baby?

You may not be aware but the the crucial period is the two weeks before you miss your period and discover that you are pregnant. During this time, you should avoid having any xrays, going on long distance flights (exposure to cosmic rays), all medicines, chemicals (especially petrochemicals), make-up eg lipstick (contains pthalates). You should stop consumption of all alcohol, smoking, perming or dying your hair, hot tubs or saunas. Of course it is not possible to avoid all contaminants but minimise them as much as possible.

Q Do I need genetic counselling before conceiving?

You should be counselled if 1. you or your spouse has a birth defect or genetic disorder, 2. you or your spouse has a child or close relative with a birth defect, mental retardation or any genetic disorder, 3. you or your spouse is a carrier of a genetic disorder such as thalassaemia, 4. you are above 35 years, 5. have had 3 or more miscarriages or stilborn foetus.

Q What is the best age to start having a baby?

Your most fertile years are in your 20's and you are less likely to run into complications. In your 30's, fertility begins to decrease and the pregnancy risks start to rise such as miscarriages, abnormalities, medical problems- hypertension, diabetes, difficult deliveries. All these rise dramatically after the age of 40. The earlier the better.

Q How long will it take for me to get pregnant?

If you have regular cycles and having sexual intercourse at the right time, it would take you on average 3 months of trying to get pregnant. The chance of pregnancy each cycle is approximately 30%. If you have tried without success for more than 6 months, then you should consult you gynaecologist to see if there is anything wrong. If after a year of trying there is almost certainly something wrong and both you and your spouse will need to see a gynaecologist.

Q What blood tests should I do prior to conceiving?

A hormone profile will indicate whether you are fertile, other tests would be tests for sexually transmitted disorders, a full blood count and electrophoresis for thalassaemia (an inherited blood disorder), and a hepatitis A,B and C screen.

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