Preconception checkup: Why you need one and what to expect

Pregnancy care by Synergy Clinic

To give your baby the best start in life, it's a good idea to get your own health squared away before you get pregnant. Think about preconception care as preventive medicine for you and for the child you're planning to conceive.

A complete medical history and physical exam a few months to a year before you start trying to conceive will help you determine what steps you may still need to take to become physically and emotionally ready to have a baby.  Synergy Clinic owned by         Dr. Pulkit Nandwani -Best Gynaecologist in Rohini will make sure that the above information will form an important baseline to refer to during your pregnancy.

Taking your history and providing counseling

The first thing we gynecologist will do is ask a long list of questions about your health and lifestyle.

Your any current or past conditions that might affect your ability to get pregnant or your health and your baby's health once you do get pregnant.

I will then share any medical concerns if needed, help you figure out how to address them, and answer as many questions and doubts you might have.

Gynecological history

I will ask you about your periods. (If you're not already keeping a menstrual calendar, now is a good time to start.) Details of kind of birth control you're using would be discussed. With certain methods, such as Depo-Provera, it may take a relatively long time for your fertility to return. Ask about switching methods if you'd like to conceive soon.

You should have Pap smears and checkup for any sexually transmitted infection (STI). Many STIs can be "silent" – meaning they don't cause any symptoms – but they can cause problems in pregnancy or fertility problems 

Obstetric history

A detailed history of pregnancies till now would be discussed.

A previous ectopic pregnancy (Pregnancy in Tubes) could make you less fertile. And if you get pregnant after an ectopic pregnancy, we may recommend a very early ultrasound to make sure this pregnancy isn't ectopic.

A history of recurrent miscarriage might mean that you should have chromosomal testing or be checked for certain health problems.

I would also want to know if you've had any pregnancy complications, how you delivered your babies and if there were any complications after delivery.

Any mental health issues (such as postpartum depression) during or after any of your pregnancies need to be fully evaluated.

Finally, she'll ask if you've given birth to a baby who had any problems. If you've had a baby with a neural tube defect, such as spina bifida, taking a much higher daily dose of folic acid before and during your next pregnancy reduces the risk of this happening again.

Medical history

A detailed history of any medical problem will be discussed, managed with optimal doses and medications will be reviewed so that it does not cause a problem to the baby during pregnancy.

Medications and allergies would be reviewed

If you're not already taking folic acid, I will advise you to start taking 400 micrograms a day (alone or in a multivitamin), beginning at least one month before you start trying to get pregnant. Taking folic acid before conception can significantly reduce your baby's risk of neural tube birth defects, such as spina bifida.

Because half of the pregnancies  are unplanned, doctors recommend that women of childbearing age take 400 micrograms of folic acid every day

Vaccination history

Contracting certain diseases during pregnancy could put your baby at risk for serious birth defects or other complications. Bring your immunization record along (if you have one) so we will know whether your vaccines are up-to-date.

Here are the recommended immunizations:

• Rubella (German measles). If you don't have documented evidence of immunity to rubella, you'll be tested for immunity. You'll need to wait a month to get pregnant after you receive a rubella shot.
•  Chickenpox. If you haven't had chicken pox or been vaccinated against it, you'll be tested for immunity. The chicken pox vaccine requires two doses, given four to eight weeks apart. You'll need to wait a month to get pregnant after you receive a chicken pox shot.
• The one-time Tdap vaccine, which includes a tetanus booster as well as a booster for pertussis (whooping cough) and diphtheria.
• The current flu vaccine.
• If you're 26 or younger and haven't had the HPV shot, we may recommend that you get one now.
•  Hepatitis B. If you haven't been immunized and are at risk for getting the disease.

Let us know if you plan to travel out of the country in the near future or during your pregnancy. Additional vaccines may be required if you travel to other parts of the world, and some are unsafe to get once you're pregnant.

Emotional and social history

Any history of mental health problems, such as depression or an eating disorder needs to be addressed.

Lifestyle questions

A Proper counselling regarding your weight , exercise program, advise you on what to avoid eating, how to avoid infections like listeriosis and toxoplasmosis that can cause problems for your developing baby, limiting your coffee or tea consumption, as some studies suggest that too much caffeine can be bad for the health of your baby, moderation of smoking and drinking. She'll want to know if you or your partner are exposed to any environmental hazards at home or work. Some toxic substances may put your pregnancy or your baby at risk. If you have any concerns about health hazards at your workplace, be sure to discuss them with your doctor.

Special attention to your oral hygiene is needed. Your gums are more likely to become inflamed during pregnancy, so brushing and flossing are especially important now.

Genetic carrier screening

You should undergo a genetic carrier screening before you start trying to conceive to see whether you or your partner is a carrier for serious inherited illnesses such as cystic fibrosis, sickle cell disease, and others.

A physical and gynecological exam is also done at Preconception visit and few tests done.

Your questions

Your preconception visit is a good time to talk about any problems or concerns you may have.

Don't be bashful. No matter how embarrassing your question may seem, we best gynecologist in Rohini deal with these issues all the time and should be able to give you good advice and make you comfortable to go ahead and plan your pregnancy confidently.