Pre-conceptional counseling is an integral part of prenatal care because the health of women during pregnancy depends upon her health before pregnancy. The main goal is to ensure that a woman is healthy before conception and to diagnose and treat any medical problems if present.
During pre-conceptional visit:
Detailed reproductive history – is taken including a number of previous pregnancies, any bad obstetric history.
Medical/surgical history – to look for any existing medical problem that can impact the health of baby during pregnancy. Optimal control of medical disease and drug with minimum toxicity to fetus and mother during pregnancy is advised.
Family history – History of hypertension, diabetes, history of twins, genetic patterns such as mentally retarded baby in the family is also recorded in detail.
Personal History – use of tobacco, caffeine, alcohol etc.increased stress can affect the health of foetus during pregnancy. She is advised to avoid above mentioned products.
Detailed physical examination including her height, weight and blood pressure is taken to detect any underlying physical problem.
Advice for women in pre-conceptional visit:
Start folic acid 5mg in a day.
Avoid smoking and alcohol
Women who are overweight, BMI >25 are advised to lose weight before becoming pregnant. Healthy weight reduces the risk of hypertension, diabetes, preterm delivery and caesarean delivery.
Minimum exposure to drugs, avoid taking the counter medicine.
A healthy balanced diet rich in fruits, vegetables, dairy products, and proteins.
Moderate physical activity can be safe, done before pregnancy eg brisk walking, yoga & aerobics etc.
Rubella vaccine: Women are routinely screened for immunity to rubella infection. Women who are not immune should be given rubella vaccine and woman is advised not to get pregnant for one month after vaccination.
Chicken pox: Women should be tested for varicella except those having a positive history of chickenpox. Women who are not immune for varicella, a vaccine is recommended.
Hepatitis B vaccine should be given to women who are at high risk of getting an infection.