Preconception care by Dr.Iqra Osman Abdullahi.pptx
- 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) 1/3/2024 2
- 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) 1/3/2024 3
- 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 1/3/2024 4
- 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. 1/3/2024 5
- 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. 1/3/2024 6
- 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. 1/3/2024 7
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- 9. Elements/components of preconception care Maternal history Maternal age factors Genetic/Family history Environmental hazards Nutritional need Social history 1/3/2024 9
- 10. MATERNAL HISTORY Reproductive life plan Reproductive history Medical history Medication use Infections and immunization 1/3/2024 10
- 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. 1/3/2024 11
- 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 1/3/2024 12
- 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 1/3/2024 13
- 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 1/3/2024 14
- 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. 1/3/2024 15
- 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. 1/3/2024 17
- 18. Smoking Alcohol Other recreational drugs: Marijuana cocaine Amphetamines Heroin Social history 1/3/2024 18
- 19. contact with some chemicals may impart significant maternal and fetal risks. Environmental exposure 1/3/2024 19
- 20. Nutritional need A women’s nutritional status may have a profound effect on reproductive outcome. Obesity Underweight 1/3/2024 20
- 21. Cont…. Supplements that may be recommended include: A balanced multivitamin/mineral supplement Iron Zinc Calcium Folate 1/3/2024 21
- 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 1/3/2024 22
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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. 1/3/2024 24
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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 1/3/2024 27
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