Why a pre-pregnancy visit?
A baby's organs start forming in the first weeks of pregnancy, often before a woman knows she is pregnant, so some steps must be taken beforehand. A preconception assessment identifies conditions that could affect the mother's health or the baby's development.
Folic acid
Folic acid helps prevent neural tube defects such as spina bifida. Start 400 micrograms a day at least one month before conception and continue for the first three months. A higher dose may be needed after a previous affected pregnancy, with certain epilepsy medicines or with diabetes.
Tests
- Full blood count and blood group
- Rubella, hepatitis B and C, HIV and syphilis screening
- Thyroid function (TSH)
- Fasting blood glucose; HbA1c for women with known insulin resistance
- Liver and kidney function tests
- Vitamin B12, vitamin D and ferritin
- Complete urinalysis
- Thalassaemia carrier screening when indicated
- SMA (spinal muscular atrophy) carrier screening
- Cervical cancer screening (HPV test or smear) if not up to date
- Gynecological examination and ultrasound
Vaccinations
Women without rubella immunity are vaccinated before pregnancy and advised to avoid pregnancy for one month afterwards. Hepatitis B and chickenpox immunity are also checked. Flu and whooping cough vaccines can be given during pregnancy.
Chronic conditions and medicines
Controlling diabetes, high blood pressure, thyroid disease, epilepsy and autoimmune conditions before pregnancy reduces risks. Some medicines are unsafe in pregnancy, so all medication should be reviewed; never stop a medicine without medical advice.
Lifestyle
- Stop smoking and alcohol completely.
- Moving towards a healthy weight makes conception easier and lowers the risk of gestational diabetes and high blood pressure.
- Limit caffeine to 200 mg a day.
- Stay physically active.
Genetic counselling
Recommended before pregnancy for consanguineous couples, families with inherited conditions, recurrent pregnancy loss or a previous pregnancy affected by a genetic condition.
Frequently Asked Questions
When should I start folic acid?
Should I see a dentist before pregnancy?
Sources
- ACOG Committee Opinion No. 762: Prepregnancy Counseling. Obstet Gynecol, 2019.
- World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience, 2016.
The information on this website is for general information only and does not replace a medical consultation.
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