Pre-pregnancy assessment

By , 27 August 2013

Pre-pregnancy assessment

 

Dr Moore offers full pre-pregnancy assessment, advice and counselling, including pregnancy risk assessment and risk management, counselling for prenatal screening, and liaison with specialists of other disciplines, as appropriate, to ensure the best management during your pregnancy, whether low- or high-risk.

Planning for pregnancy

Planning to start (or expand!) a family is an exciting time in our lives, and it is quite natural to want as healthy a pregnancy as possible.  For many, pregnancy need only be excitedly awaited with a few lifestyle “adjustments”, such as folic acid supplementation and cessation of smoking.  For others, however, some pre-existing medical conditions may require careful optimisation prior to attempting to conceive, to ensure the best possible outcome for mother and baby.  These conditions may include thyroid problems, high blood pressure, diabetes, or heart conditions.  Others still, may be aware of conditions that “run in the family”, and desire genetic counselling before planning a pregnancy.

The following is an outline of some general pre-pregnancy advice and recommendations.

How long will it take me to conceive?
Pre-pregnancy screening
Nutrition and exercise
Folic acid supplementation
Iodine supplementation
Medications
Smoking and alcohol
Additional information
 

How long will it take me to conceive? top

Healthy couples have about a 20% chance of falling pregnant with each month of regular, unprotected intercourse.  This doesn’t sound very high, but it is entirely normal!  Within the first 12 months of trying to conceive, about 90% of couples will be successful.  Women over the age of 35 may take longer to conceive naturally.  Talk to your General Practitioner if you have concerns about your fertility, and they can arrange appropriate tests and referral, if necessary.

Pre-pregnancy screening top

This generally includes a full review of your medical history, a physical examination, a Pap smear (if due), and some blood tests.  Your doctor will determine your blood group and blood levels, as well as your susceptibility to some important infections, such as the rubella virus.  Depending on your particular circumstances, your doctor may order additional tests such as varicella (“chicken pox”) and parvovirus (“slapped cheek disease”) susceptibility, or check your thyroid function with blood tests.  Sometimes, your General Practitioner or Specialist may recommend vaccinations prior to pregnancy, such as vaccinations to rubella, varicella, or influenza.

Nutrition and exercise top

Women planning a pregnancy should aim to eat a healthy, balanced diet (as should the rest of us!).  Generally, most meals should be comprised mainly of complex carbohydrates (such as bread, cereals, pasta, potatoes and rice), with fruit and vegetables.  Protein-rich foods (such as meat, chicken, and fish) should be consumed in moderation.  Include foods that are rich in calcium, iron and folic acid, and try to limit saturated fats and simple carbohydrates (sugar).  Once pregnant, a woman’s energy requirements increase by about 200 Calories per day above her normal requirements.

Regular exercise is part of a healthy, balanced lifestyle, and can continue pre-pregnancy and even well into your pregnancy.  However, high levels of intense exercise can be associated with difficulty falling pregnant.  It is best to avoid overheating during exercise (as this may harm a fetus), by drinking plenty of water and not exercising at hot times of the day.  Contact sports won’t impair your ability to fall pregnant, but should generally cease after 12 weeks of pregnancy.
 

Folic acid

All women planning a pregnancy are recommended to have folic acid supplementation, ideally from three months before conception and for the first three months of pregnancy.  Supplementation reduces the risks of having a baby with spina bifida or other neural tube defect.  Most readily-available supplement tablets contain 0.5mg (500 micrograms) of folic acid, and this easily meets the recommended daily dose.  Some groups of women, such as those with diabetes or epilepsy, may be at higher risk and should discussed this with their General Practitioner or Obstetrician.

Iodine

Many Australian women do not receive enough iodine from their diet alone (although this has improved with iodine fortification of some foods).  Iodine is an essential for production of thyroid hormones, which play an important role in the neurological development of your baby.  Although frank iodine deficiency is rare in Australia, women planning pregnancy are advised to supplement their diet with 150 micrograms of iodine daily.  Most commercially-available pregnancy multivitamins meet this requirement, although checking the label is recommended.

Medications top

The use of prescription medications requires special attention prior to, and during, pregnancy.  In many cases, these medications can (and should) be continued during pregnancy (such as asthma and thyroid medications).  Others, such as blood pressure medications, may need to be substituted for safer alternatives.  Some may need to be ceased, and the implications of this need to be thoroughly considered.  You should not cease any regular medication without prior discussion with your General Practitioner or Specialist.  The use of over-the-counter medications, including multivitamins, should also be discussed with you General Practitioner or Specialist, as some may be harmful in pregnancy.

Smoking and alcohol top

Smoking is not advised during pregnancy, and should ideally be stopped a few months before conception.  Passive smoke is also harmful, so a healthy pregnancy should be a strong motivator for the mum-to-be, her partner, and those who live in the same household, to quit smoking.

Although some studies provide reassurance for women who have unknowingly consumed alcohol in early pregnancy, there remains no proven safe level of alcohol consumption during pregnancy.  As such, complete alcohol avoidance is recommended during, and while planning, a pregnancy.

Additional information top

Your General Practitioner is well-placed to discuss plans for pregnancy with you, as they are often quite familiar with your personal medical history and can implement routine pre-pregnancy screening tests and evaluations.  Depending on your personal circumstances, your General Practitioner may recommend referral to a Specialist Obstetrician to discuss your pre-pregnancy management in more detail.

 

The content and information contained on this website is intended to be of a general nature only and is not intended to, nor does it constitute, medical advice.  It does not take into account your particular circumstances or needs.  No doctor/patient relationship is implied or formed. The accuracy, completeness, adequacy, or currency of the content is not warranted or guaranteed. Use of information on this website, or materials linked from the website, is at the user's own risk.  The contents of the site, such as text, graphics, images and other materials are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should always seek the advice of their qualified health providers with any questions regarding a medical condition. Users should never disregard professional medical advice or delay in seeking it because of something on this website.  Specific recommendations can only be made after direct individual consultation.  The website does not recommend or endorse any specific tests, products, procedures, or other information that might be mentioned on the website.

 
Pre-pregnancy assessment
 

About Dr David Moore

Pre-pregnancy assessment

David is a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, and undertook his specialist training in Queensland.  He is highly skilled in the management of complex and high-risk pregnancies, and has special training in minimally-invasive surgery, endometriosis, pelvic floor and incontinence surgery.  David has completed a Master of Reproductive Medicine and is skilled in the assessment and management of fertility problems, and can offer the full range of assisted reproductive treatments.  He is a Senior Lecturer with The University of Queensland Medical School, and has published both medical journal and textbook contributions.

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