Dr Chang T.C.

Obstetrics Pre-pregnancy Care

The goal of preconception care is health education and promotion, risk assessment, and intervention before pregnancy begins to reduce the chances of poor perinatal outcomes.

It is targeted at the mother, father, and family to reduce maternal and infant morbidity and mortality. Preconception counselling and education must include early health promotion and information to guide families in identifying risks and addressing those risks before pregnancy.

During a preconception office visit, you and your doctor will discuss your:

Reproductive history

This includes previous pregnancies, your menstrual cycle, use of contraception and previous Pap smear abnormalities

History of recurrent (> 3) miscarriages

A detailed examination and series of blood investigations may be needed to ascertain the likely cause of recurrent miscarriages, including Protein-S deficiency, Factor V Leiden, MTHFR, anti-phospholipid syndrome, thyroid disorders and inheritable chromosome abmormalities

Medical history

Any health disorders need to be optimised before you get pregnant.

Vaccination history

to ensure that you are protected against Rubella.

Surgical history

Have you had any surgeries, transfusions, hospitalizations in the past? If so, tell your doctor. Inform your doctor of any gynaecologic surgeries you may have had, including surgeries for fibroids or abnormal pap smears (eg cone biopsy, LLETZ / laser treatment / loop excision of the cervix)

History of medications

Tell your doctor about any current medications you are taking or in the past 6 months. In some cases, it may be time to make a change to help prevent birth defects including medications like Ro-Accutane, isotretinoin, medications for blood pressure, thyroid disorders or epilepsy

Family history

Tell your doctor about any medical conditions that run in your family, such as diabetes, hypertension, or history of thrombosis

Lifestyle changes

Optimise your health by quitting smoking and drinking alcohol

Exercise

Do you exercise regularly or do you lead a sedentary life-style?

Diet

Your doctor will ask you about what you eat and drink. It's ideal to go into pregnancy with good dietary habits already established. Enjoy a variety of foods rich in fiber, and getting enough calcium, folic acid, and other nutrients.

Home and work environment

Identify possible risks eg. exposure to radiation or chemicals / solvents that may affect your ability to become pregnant or maintain a healthy pregnancy.

Your weight

It's a good idea to reach your ideal body weight before you get pregnant. This means losing weight if you are overweight to reduce your risk of complications during pregnancy; or gaining weight if you are underweight to reduce the risk of delivering a low birth-weight baby.

Prenatal vitamins

Before pregnancy begins, you should be taking a folic acid supplement. Folic acid makes it less likely that your baby will have a neural tube defect, and it's best to start taking it before you conceive. Your doctor will likely recommend taking 500 micrograms (mcg) of folic acid daily before conception and in early pregnancy.

Caffeine

When you are pregnant, your doctor may recommend limiting caffeine to no more than 300 mg per day. That's about the amount in two cups of coffee.