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