Preconception care
1.Introduction
Pregnancy may be associated with certain diseases that existed before the inception of pregnancy. As a rule, all diseases which subject the organism to a considerable strain are much more serious when occurring in a pregnant woman. —
J. Whitridge Williams (1903)
2.Definition
“a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman’s health or pregnancy outcome through prevention and management.”
(CDC’s select panel of preconception care, 2015)
3.OBJECTIVES
Improve knowledge, attitudes, and behaviors of men and women related to periconceptional health
Assure that all childbearing-aged women receive periconceptional care services —including evidence-based risk screening, health promotion, and interventions —that will enable them to enter pregnancy in optimal health
4.Reduce risks indicated by a previous adverse pregnancy outcome through interconnectional interventions to prevent or minimize recurrent adverse outcome
Reduce the disparities in adverse pregnancy outcomes To illustrate potentially modifiable conditions.
5.Components
Early detection and prevention of health risks.
Management of high risks before conception.
Active management of fertility.
Creation of awareness regarding contraception among women.
6. COUNSELING SESSION
Gynecologists, internists, family practitioners, and pediatricians have the best opportunity to provide preventive counseling during periodic health maintenance examinations.
The occasion of a negative pregnancy test is also an excellent time for education.
7.
8. COUNSELING SESSION
Gynecologists, internists, family practitioners, and pediatricians have the best opportunity to provide preventive counseling during periodic health maintenance examinations.
The occasion of a negative pregnancy test is also an excellent time for education.
9.Elements/components of preconception care
Maternal history
Maternal age factors
Genetic/Family history
Environmental hazards
Nutritional need
Social history
10.MATERNAL HISTORY
Reproductive life plan
Reproductive history
Medical history
Medication use
Infections and immunization
11.Medical history
With specific medical conditions, general points include how pregnancy will affect maternal health and how a high-risk condition might affect the fetus.
Diabetics
Epilepsy
Treated or active cancer
Prior peripartum cardiomyopathy
systemic lupus erythematosus.
12.Reproductive history
During preconceptional screening, information is sought regarding:
infertility; abnormal pregnancy outcomes that may include miscarriage, ectopic pregnancy, and recurrent pregnancy loss; and obstetrical complications such as cesarean delivery, preeclampsia, placental abruption, and preterm delivery, a prior stillbirth
13.Immunization
Periconceptional counseling includes assessment of immunity against common pathogens.
Vaccines that cont
2. Introduction
•Pregnancy may be associated with certain diseases
that existed before the inception of pregnancy. As a
rule, all diseases which subject the organism to a
considerable strain are much more serious when
occurring in a pregnant woman. —
J. Whitridge Williams (1903)
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3. Definition
• “a set of interventions that aim to
identify and modify biomedical,
behavioral, and social risks to a
woman’s health or pregnancy outcome
through prevention and management.”
(CDC’s select panel of preconception care, 2015)
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4. OBJECTIVES
Improve knowledge, attitudes, and behaviors
of men and women related to
periconceptional health
Assure that all childbearing-aged women
receive periconceptional care services —
including evidence-based risk screening,
health promotion, and interventions —that
will enable them to enter pregnancy in
optimal health
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5. Reduce risks indicated by a previous adverse
pregnancy outcome through
interconnectional interventions to prevent or
minimize recurrent adverse outcome
Reduce the disparities in adverse pregnancy
outcomes To illustrate potentially modifiable
conditions.
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6. Components
• Early detection and prevention of health
risks.
• Management of high risks before
conception.
• Active management of fertility.
• Creation of awareness regarding
contraception among women.
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7. COUNSELING SESSION
• Gynecologists, internists, family
practitioners, and pediatricians have the
best opportunity to provide preventive
counseling during periodic health
maintenance examinations.
• The occasion of a negative pregnancy test is
also an excellent time for education.
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9. Elements/components of preconception care
Maternal history
Maternal age factors
Genetic/Family history
Environmental hazards
Nutritional need
Social history
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10. MATERNAL HISTORY
Reproductive life plan
Reproductive history
Medical history
Medication use
Infections and immunization
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11. Medical history
With specific medical conditions, general points
include how pregnancy will affect maternal
health and how a high-risk condition might affect
the fetus.
Diabetics
Epilepsy
Treated or active cancer
Prior peripartum cardiomyopathy
systemic lupus erythematosus.
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12. Reproductive history
During preconceptional screening, information
is sought regarding:
infertility; abnormal pregnancy outcomes that
may include miscarriage, ectopic pregnancy,
and recurrent pregnancy loss; and obstetrical
complications such as cesarean delivery,
preeclampsia, placental abruption, and
preterm delivery, a prior stillbirth
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13. Periconceptional counseling includes assessment of
immunity against common pathogens.
Vaccines that contain toxoids such as tetanus are suitable
before or during gestation.
Also, those containing killed bacteria or viruses—such as
influenza, pneumococcus, hepatitis B, meningococcus, and
rabies vaccines—are not associated with adverse fetal
outcomes and are not contraindicated preconceptionally
or during pregnancy.
Conversely, live-virus vaccines are not recommended
during pregnancy.
Immunization
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14. Women at both ends of the reproductive-
age spectrum have unique outcomes to be
considered.
Age of mother before conception that
mother is below 17 years or above age of
35 years
Maternal age factors
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15. The ages of 15 and 19 years are at increased risk for
anemia, preterm delivery, and preeclampsia
compared with women aged 20 to 35 years (Usta,
2008).
after age 35, the risks for obstetrical complications
and for perinatal morbidity and mortality rise.
The older woman who has a chronic illness or who is
in poor physical condition usually has readily
apparent risks.
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17. Genetic/Family history
The health and reproductive status of each “blood
relative” should be individually reviewed for
medical illnesses, mental retardation, birth
defects, infertility, and pregnancy loss. Certain
racial, ethnic, or religious backgrounds may
indicate elevated risk for specific recessive
disorders.
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18. Smoking
Alcohol
Other recreational drugs:
Marijuana
cocaine
Amphetamines
Heroin
Social history
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19. contact with some chemicals may impart
significant maternal and fetal risks.
Environmental exposure
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20. Nutritional need
A women’s nutritional status may have a
profound effect on reproductive outcome.
Obesity
Underweight
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21. Cont….
Supplements that may be recommended
include:
A balanced multivitamin/mineral supplement
Iron
Zinc
Calcium
Folate
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22. Eating a well balanced diet is ideal
and drinking plenty of water (10-
12 glasses per day) is ideal.
To take at least 400 micro grams
of folic acid per day for at least on
prior to pregnancy
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24. SCREENING TESTS
Certain laboratory tests may help assess the
risk for and prevent some pregnancy
complications.
These include basic tests that are usually
performed during prenatal care.
More specific tests may assist evaluation of
women with certain chronic medical
diseases.
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27. CONCLUSION
Periconceptional care is very essential
to improve the maternal health and
pregnancy outcome as well as it helps
to detect any pregnancy abnormality
which can affect mother and baby
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