An scrúdú réamh-ghlactha: riachtanach sula mbíonn leanbh agat

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An scrúdú réamh-ghlactha: riachtanach sula mbíonn leanbh agat

Having a baby is getting ready. Before having a baby, it is indeed recommended to carry out a preconceptional visit in order to put all the chances on his side to be pregnant and have a pregnancy without complications. Focus on the importance and content of this special future mother health check-up.

Why consult your doctor for a baby plan?

Having a health check-up before a pregnancy plan allows you to uncover possible factors that could affect fertility, to start a healthy pregnancy and to detect a possible problem that the pregnancy could worsen. In short, it is about bringing together all the conditions to get pregnant and for this pregnancy to go as well as possible.

The preconception examination is recommended by the Haute Autorité de Santé (1) for all women who plan to have a baby. It is essential in the event of a serious obstetric complication during a previous pregnancy or of a child suffering from a severe pathology. This consultation can be carried out with an attending physician, a gynecologist or a midwife, and must take place before starting the “baby tests”, ideally in the presence of the future dad.

The content of the preconception examination

This preconception visit includes different components:

  • Un general examination (height, weight, blood pressure, age).

Particular attention is paid to weight because being overweight can decrease fertility and increase the risk of complications during pregnancy. Likewise, extreme thinness can adversely affect fertility. Even before considering pregnancy, nutritional support can therefore be recommended.

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  • a gynecological examination

To check if the uterus and ovaries are normal, a palpation of the breasts. In the absence of a smear less than 3 years old, a smear is performed as part of the screening for cervical cancer (2).

  • study of obstetric history

In the event of a complication during a previous pregnancy (hypertension, gestational diabetes, premature delivery, growth retardation in utero, fetal malformation, death in utero, etc.), possible measures may be implemented to avoid a recurrence during a future pregnancy.

  • an update on the medical history

In the event of illness or a history of illness (cardiovascular disease, epilepsy, diabetes, hypertension, depression, cancer in remission, etc.), it is essential to take stock of the consequences of the disease on fertility and pregnancy but also on those of pregnancy on the disease, as well as on the treatment and adapt it as needed.

  • family history study

In order to search for a hereditary disease (cystic fibrosis, myopathies, hemophilia…). In some cases, a genetic consultation will be recommended in order to assess the risks for a possible unborn baby, the possibilities of diagnosis and treatment.

  • tástáil fola

To establish the blood group and rhesus.

  • a review of vacsaíní

By means of the vaccination record or health record. A blood test is also taken to check immunization to various infectious diseases: rubella, hepatitis B and C, toxoplasmosis, syphilis, HIV, chickenpox. In the event of non-immunization against rubella, it is recommended to be vaccinated before the planned pregnancy (3). For people over 25 years of age who have not received a pertussis vaccine booster, a catch-up can be performed up to age 39; it is strongly recommended for couples having a parental plan before the very beginning of pregnancy (4).

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  • un dental check-up is also advised before pregnancy.

Daily preventive measures

During this pre-conceptual visit, the practitioner will also focus on taking stock of the couple’s lifestyle in order to identify possible risk factors for fertility and pregnancy, and to issue advice in order to limit them. . Notably :

  • prohibit the consumption of alcohol from the period of conception
  • stop using tobacco or drugs
  • avoid self-medication
  • limit exposure to certain chemicals

In the event of non-immunization against toxoplasmosis, the woman will have to take some precautions from the period of conception: carefully cook her meat, avoid eating raw egg-based foods, raw milk-based foods (cheeses in particular) , raw, salted or smoked cold meats, wash fruits and vegetables intended to be eaten raw, wash your hands thoroughly after gardening, entrust the changes of the cat’s litter to your companion.

 

Recommend taking folate

This pre-conceptual visit is finally the opportunity for the doctor to prescribe folate supplementation (or folic acids or vitamin B9) because a deficit is associated in the fetus with an increased risk of neural tube closure abnormalities (AFTN ). To prevent these serious malformations, supplementation is recommended at the level of 0,4 mg / day. This intake should be started as soon as the woman wishes to become pregnant and continued until 12 weeks of gestation. For women with a history of fetuses or newborns with AFTN or those treated with certain antiepileptic drugs (which may induce folate deficiency), supplementation of 5 mg / day is recommended (4).

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