Early-Pregnancy Counselling

EARLY PREGNANCY COUNSELLING

The aim is to help prospective parents embark upon pregnancy under conditions most likely to ensure optimal well being for the fetus. Babies conceived 18-23 months after a live birth have the lowest rate of perinatal problems. Ensure that a woman is rubella  https://en.wikipedia.org/wiki/Rubella_virus
and chicken pox immune prior to pregnancy and all women should have their need for thromboprophylaxis in pregnancy considered.



                              Person Holding Babys Hand


Other areas covered include:
  • Optimal control of chronic disease example, diabetes before conception. This is also important for hypothyroidism as the fetus cannot make thyroxine until 12-weeks and under-replacement may effect neurodevelopment. 
  • Stop teratogens or seek expert advise before conception.
  • Medication to protect the fetus from abnormality example folate supplements for neural tube defects.
  • Provide expert information for those at risk of abnormality so pregnancy and its avoidance is an informed choice, and any test needed are planned.
  • If past / family history of thromboembolism, then screen for thrombophilia.
DIET : To prevent neural tube defect and cleft lip, all should have folate rich foods and folic acid 0.4mg  from before conception to 13th week of pregnancy.


                             Fresh vegetables and fish on cutting board in kitchen


These FOODS have >0.1mg of folic acid per serving: Brussels sprout, asparagus, spinach, black eye beans, fortified breakfast cereals. Avoid liver and vitamin A to protect from embryopathy risk.

SMOKING : decreases ovulations, causes abnormal sperm production, rate of miscarriage is high and assosiated with preterm labour.

ALCOHOL CONSUMPTION :  High level of consumption are known to have fetal alcohol syndrome, moderate drinking has not been shown to adversely affect the fetus but alcohol does cross the placenta and may affect the fetal brain. Miscarriage rate is higher among drinkers of alcohol.
nice recommends < 1 unit / 24 hr.

SPONTANEOUS ABORTION :  At least 12% of first pregnancies spontaneously abort
more recent live births less chances of miscarriage.

RECURRENT MISCARRIAGES :  Possible causes are endocrine, polycystic ovaries 
bactarial vaginosis, parental chromosomal abnormality, Uterine abnormalities 
anti phospholipids antibodies, Allimmune causes.

SEARCH FOR THOSE WHO NEED COUNSELLING  MOST 

Diabetes Mellitus
Tropical travellars
Frequent abortions
Hypothyroidism
Epilepsy
Rubella
Pet-owners
Phenyleketonuria
BP high
SLE
Genetic history
Thalassaemia
Duchenne's
Cystic fibrosis
https://www.passtechusa.com/q2phtzgqx7?key=88fe04bc96cdf01fb18ff62d0b62208c

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