Consultant & Unit Head, Dept. Of Obstetrics & Gynecology

PRECONEPTION CARE

Dr Nupur Gupta

WHAT IS PRE-CONCEPTION?

• Starts before conception

• Promoting health of women of

childbearing age

• Helps to improve maternal health

• Step towards desired outcome

WHAT IS PRE-CONCEPTION?

• Health of baby highly related to parents

health

• Trying to have a baby- understand it

• Prepare for safe pregnancy & a healthy baby

• Speak with the doctor about this

• Critical development period of baby- starts-

before mother know pregnancy

Mission of Preconception

• Improve & manage maternal

health conditions

• Improve & manage early fetal

development

• Encourage emotional well being

• Modify risk factors

Aim of Preconception Care

• Finding & taking care of any problems

• Steps to reduce risk of birth defects

• Care of health issues before pregnancy

• Prevent many future problems for mother

& baby

Planning your pregnancy

• Best thing to plan ahead

• Planning a pregnancy means

• To have a healthy baby

• Making decisions with partner

about future family

Planning your pregnancy

• Whether you are ready for

pregnancy?

• Life changes during pregnancy &

after delivery

• Planning for this- much easier to

handle it- both partners

Understanding your fertile period

• With regular cycles- D9-D16

• Timed intercourse- 1- 2 days prior to ovulation

• Best time to conceive-

• Life span of ovum is 24hrs, sperms is 3-5 days

• How to predict ovulation-

• Temperature chart

• LH kit

Effect of weight on fertility

• BMI• Positive effect of weight loss (10%)

Effect of age

• Fertility goes down with age , specially after mid 30s

• Less chances of success in fertility treatment

Time to consult your doctor when

• Age >35 yrs- no conception till 6 months

• Age< 35yrs- no conception till 1 yr

Why is planning important?

• Help to have a healthy baby

• Planned babies are more healthy

than unplanned babies

• By more early & regular prenatal

care, we can achieve a healthier

pregnancy

How can you plan your pregnancy?

• Interact with your partner

• Decide number of children to have

• Spacing between two births

• Care for mother’s health

Things to consider

• Sexually active but one partner not ready -

use contraception

• Consult your doctor

• Think about what it is like to be a good

parent

• Becoming parent is a big responsibility

Financial Planning

• Talk to your partner freely about

having a baby

• Financial planning for your baby

• Having a baby can be expensive

• Look for health insurance & financial

schemes

Finding emotional readiness

• Why to have a baby?

• Are both partners ready for the changes

affecting your relationship?

• If you’re not in a relationship, are you

prepared to raise a child alone?

• How will a baby affect your education or

career plans?

Finding emotional readiness for newborn care

• How to take care of a child? • Are you prepared to parent a child who is

sick or has special needs? • Are you ready to have less free time for

yourself? • Can you see yourself enjoying your time as a

parent? • What do you want for your baby's childhood

that may have been missing from your childhood?

Elements in Preconception care

• Visit to doctor ( 3-6 months prior to

conception)

• Risk assessment

• Education & health promotion

• Medical & psychosocial care

Components of Preconception Care

• Medical history

• Psychosocial issues

• Physical examination

• Investigations

• Family or genetic history

• Nutrition

• Occupational or environmental risk factors

Risk Assessment

• STD evaluation

• Genetic issues

• Domestic violence

• Substance abuse

Alcohol, Tobacco

Drugs

Environmental teratogens

• Exposure to hazardous materials

Home, workplace, environment

• Physical or chemical hazards

Ionizing radiation, lead, mercury,

hyperthermia, herbicides,

pesticides

Health Education

• Stop smoking

• Start intake of folic acid

• Multivitamins

• Genetic counselling

• Dietary & nutritional advice

• Rubella Immunisation

Things to control

• Weight

• Alternate medications

• Stop Alcohol/ tobacco

• Correction of cardiac problems

• Sugar control

• R/o safe anticonvulsants if epileptic

• Unhealthy diet & sedentary life style

Diseases that affect mother & baby

• Diabetes

• Hypertension

• Cardiac problems

• Epilepsy

• Thyroid disorders

• HIV infection/ STDs

• SLE

• Renal disorders

• Blood disorders & cancers

Interventions to be avoided during pregnancy

• Rubella & varicella vaccination

• Narcotic detoxification

• Certain radiological procedures

• Thyroid ablation with radioactive

iodine

Factors affecting conception

• Birth spacing

• Genetic diseases

• Diseases with poor prognosis ( HIV/AIDS)

• Life threatening diseases

• Poor maternal care

• Repeated fetal loss or abortions

Benefits of Preconception Care

• Improved outcome

• Decreases fetal or infant mortality &

morbidity

• Decreases maternal mortality & morbidity

Factors that lower birth defects

• Optimal glycaemic control

• No alcohol consumption

• No smoking

• Preconception rubella immunization

• Folic acid supplementation

Barriers to Preconception Care

• High rate of unintended pregnancies

• Unawareness about preconception health

• Ignorance about health issues

• Limited access to health services

• Inadequate knowledge

Preconception care for men

• Stop alcohol

Causes physical & emotional

abuse

Decrease fertility

• Genetic counselling

• Decrease fertility with age

• No hot bath, hot tub or sauna

• No tight undergarments

• Occupational hazards awareness

• Knowledge & information about

STDs, Syphilis, Herpes, HIV/AIDS

Overview of preconception care

• Take care of oral health

• Quit smoking and drinking

• Cut off caffeine intake

• Healthy nutritious diet

• Weight control, Up to date vaccine

• Care of medications

• Exercise

Early Signs of Pregnancy

• Missed period

• Frequency of urine

• Feeling of tiredness easily

• Nausea in the morning

• Breast tenderness & enlargement

THANK YOU