Please enable JavaScript.
Coggle requires JavaScript to display documents.
Preparing for pregnancy/ pre-pregnancy counselling (Lifestyle factors…
Preparing for pregnancy/
pre-pregnancy counselling
Timing
Identify and address specific issues beforehand
Fit and healthy beforehand with minimal toxin exposure
Begin before conception, as foetal development begins
1 week after conception (3 weeks after LMP)
Contraception
Coil
No fertility delay
Pill
No clear delay
Advised to wait 3m after before trying to concieve
IM injection
Delay in return to fertility for several months
Lifestyle
factors
Exercise
Bad
High-impact, vigorous sports
Scuba diving (birth defects, fetal decompression)
Good
Moderate exercise e.g. low-impact aerobics, swimming, brisk walk, jog
Not associated with adverse outcome
Alcohol
Miscarriage, birth defects, foetal alcohol syndrome
Avoid/limit 1u/d
Diet
Foods
Include: well balanced diet of protein, dairy, starch, fruit, veg
Avoid: liver/pate (vit A), soft cheese, undercooked eggs/meat, shellfish/raw fish (Salmonella/Listeria), caffeine
Supplements
All: folic acid 0.4mg/d before preg up to 12w (high risk NTD 5mg/d)
As needed: Fe, Ca, Zn (preterm labour, growth restriction),
I (neonatal hypothyroidism)
Avoid: vitamin A (teratogenic)
BMI
Reduced fertility BMI>30 or <18.5
Obesity high risk of gestational DM, HTN, maternal death
Poor nutrition bad for mother and baby
Weight gain
350 extra calories/day
Gain should be 11-16kg
Smoking
Miscarriage, placenta preva, abruption, preterm labour, SGA
Smoking cessation
Recreational drugs
Miscarriage, preterm birth, poor development, death
Addiction cessation support
Work
Safe to continue, unless hazardous environment
(e.g. chemical factories, X-rays, operating theatres)
Computers not linked with adverse outcomes
Older mothers
Risk factor for adverse outcome
Conception
Reduced >35y, rapid drop by 40y
Chr abnormalities
Increased risk
Commonest is Down's syndrome
Pregnancy complications
Pre-eclampsia, gestational DM
Maternal disease
Systemic disease
E.g. DM, hypothyroidism, HTN, SLE, epilepsy
Optomise management
Genetic disease
E.g. thalassemia, sickle cell, DMD, CF
Genetic counselling as appropriate
Indication
Specialist team if
specific risks identified
Medications
Stop
Teratogens e.g. AEDs, Li
Start
Rubella vaccine prior to conception (avoid preg 3m)
VTE thrombophylaxis if needed