Pregnancy can be a time of great change. While it can be joyful and very exciting, it can also place…
What is a pre-pregnancy check-up?
Pre-pregnancy check-ups are promoted as a way to improve pregnancy outcomes by identifying risk factors that can result in complications. The provision of information about lifestyle factors such as diet, smoking and alcohol intake allows individuals to make healthy informed decisions about their pregnancy in the hope it will lead to better outcomes and lessen pregnancy complications.
During the check-up
During your pre-pregnancy check-up, you can expect your doctor to take a detailed medical history from you and your partner. Diet and lifestyle factors will also be taken into consideration, with folate supplements and stress management techniques often recommended.
It is likely that your doctor will also take a blood sample and Pap test for analysis (if not up to date), to ensure you do not have any underlying medical conditions that might affect your pregnancy.
It is important that your vaccinations are up-to-date. Some vaccines are associated with complications during pregnancy, so it is sometimes advised to wait about a month before trying to conceive after receiving such vaccines. Your doctor can advise you which vaccines are safe to use and which ones you may need to wait to have.
Your doctor may also test for a range of illnesses including thyroid problems (hyperthyroidism / hypothyroidism), toxoplasmosis, chickenpox, HIV, hepatitis B, and other sexually-transmitted infections. Some conditions, such as sickle-cell anaemia and thalassaemia, can be passed down generations in people of certain ethnic backgrounds. Depending on your ethnicity, you may be tested to see your risk of passing these conditions on to your newborn.
Disease management in pre-pregnancy
It is important to seek medical advice before trying to conceive if you have a medical condition that puts you at increased risk, such as diabetes, epilepsy, high blood pressure (hypertension), or asthma. Some medications you might be taking for these conditions may cause complications for your pregnancy. If this is the case, your doctor might suggest substitute medications.
For those with diabetes it is especially important that blood sugar levels be controlled to ensure the health of mother and baby. Management for diabetes during pregnancy may be a controlled dietary intake and lifestyle measures with or without insulin. Hypoglycaemia (low blood sugar) more often occurs overnight, between 6-18 weeks' gestation, during which time insulin intake may need to be decreased. After that time, resistance to insulin increases, so insulin may need to be increased until around 32 weeks when blood sugar levels may fall again. Your doctor will explain all of this during your pre-pregnancy check up and may involve a specialist endocrinologist in your care.
High blood pressure
If you know you have high blood pressure (hypertension), it is important to have a pre-pregnancy check-up before you try to get pregnant, because some medications used to control hypertension can cause complications. You will also need to be advised on the process of managing your condition during pregnancy. If you do not have it previously, sometimes hypertension can develop during pregnancy, so it is important to have blood pressure checks at antenatal visits.
Heart disease is one of the most common causes of maternal death during pregnancy. Pregnant women with a heart disease (such as angina or atrial fibrillation) are at higher risk due to the heart working harder during pregnancy than it normally does. Many of the medications used for treating heart disease can cause developmental issues for the baby. It is important to speak to your doctor prior to pregnancy so that a medication regime can be optimised to ensure the health of you and your baby.
Hormonal and other changes during pregnancy can alter the effects of antiepileptic drugs during pregnancy, resulting in complications to the baby. Your doctor will discuss options to manage your epilepsy during pregnancy.
Asthma can often become worse during pregnancy, so if you have asthma, pre-pregnancy check-up can help prepare you to manage it. It is important to keep taking your medications as prescribed by your doctor for your asthma during pregnancy. The medications used to treat asthma are generally much less likely to harm your baby than the actual effects of asthma.
It is recommended that you see your doctor before you become pregnant, because a pre-pregnancy check-up can help to reduce the risks of pregnancy to you and your child.