Since 2005 a new concept has been incorporated “preconception care”Until then, the focus was on the importance of starting early check-ups in pregnancy, but not before it. Although the controls were early, maternal conditions and fetal malformations were diagnosed, sometimes severe, which could have been avoided if the previous consultation was carried out. In general, health problems in pregnancy are already present in women since before conception or at least risk factors for their appearance.
Obstetric care has not changed much in recent decades and has barely managed to affect the two main problems that contribute the most to infant morbidity and mortality in our environment: congenital malformations and low birth weight.
Preventive activities have shown their usefulness in reducing infant morbidity and mortality. However, much work remains to be done. Today only 10-20% of women voluntarily attend the consultation.
There are numerous educational and promotional actions that the gynecologist can provide in preconception consultations, in order to provide information on the pros and cons of certain habits and situations that will help women achieve better results in their pregnancy and avoid possible risks.
What measures would be most effective if taken on time?
1. Modification of treatments for chronic diseases, by drugs suitable for pregnancy.
2. Disruption of harmful behaviors: tobacco, drug use, alcohol.
3. Vitamin Supplements: Intake of folic acid 3 months prior to the search.
4. Nutritional counseling
5. Update the vaccination schedule: Tetanus, rubella, chicken pox, measles, mumps, hepatitis B, Sarscov2
6. Investigation of infectious diseases. Those that are treated promptly reduce fetal risk, such as HIV and other STIs (sexually transmitted infections)
7. Stress management, including detection of gender violence.
8. Genetic counseling.
Today there are studies that allow predicting the risk that a couple has of having a child affected by a genetic disease. These tests allow us to assess whether future parents are carriers of a recessive or X-linked disease. The carrier is a healthy person, but can transmit the mutation to their offspring; If both parents are carriers of the same mutation, they have a 25% risk of passing it on to their baby.
These tests allow us to study at the same time between 400 to 600 diseases And it can be done by any couple planning a spontaneous pregnancy or with fertility treatment, without the need for a genetic background of any kind.
Another important aspect to take into account is the age of the woman, a key figure in both the psychological and physiological impact, when facing a gestational search. Adolescents, who frequently have unwanted pregnancies, suffer negative psychological consequences, and are at increased risk of low-birth-weight babies, premature infants, or children at increased risk of infant mortality. The causes are not clear, but it is believed that they may be influenced by biological immaturity, low social status, inadequate preconception and prenatal care, or poor nutritional status.
PREGNANCY
Lucas Mendes / Pexels
On the other hand, delayed maternity above 35 years of age can be associated with infertility problems and obstetric pathology such as intrauterine growth retardation of the fetus, gestational diabetes or pre-eclampsia. Pregnancies over 38 years of age carry an increased risk of chromosomal (genetic) alterations, simply influenced by maternal age.
Without a doubt, the trend in health is down the path of prevention, early detection, planning and personalized medicine. These actions not only allow us to assume a pregnancy with satisfactory results, but also reduce the presence of complications of different types in the mother and the child.
Reproductive Medicine Specialist (MN No. 123,756).
Source From: Ambito
