Pre-pregnancy Tests
"The idea of pregnancy is the first step towards motherhood"
Some pregnancies have the chance to be followed up by a physician who is well planned and well controlled from the beginning to the end; unfortunately this is not possible in most cases.
Pregnancy and the intentional decision of the pregnant mother will be conscious before pregnancy will prevent many discomforts that may arise during pregnancy.
Sometimes after a completely unexpected (random) pregnancy, especially the first three months of pregnancy can be a difficult adaptation problem. However, after the psychological acceptance of the pregnancy, a relief is felt and most of the problems are resolved. The most common mistake made here is the immediate decision to abort the pregnancy.
If you are considering a pregnancy;
Before you become pregnant, it is a good idea to go and examine your doctor. After the examination, many problems related to your genital area will be solved. Because, many treatment methods and drugs can not be applied during pregnancy because of the negative effects on your baby.
Having some tests before pregnancy will make it very easy for you to monitor your pregnancy.
These tests:
Blood group
Pelvic ultrasonography
Complete urinalysis
Complete blood count
Routine biochemistry (Fasting blood sugar, urea, creatinine, SGOT, SGPT),
Bleeding profile (bleeding and clotting times, APTT, PTT, fibrinogen)
TORCH tests (Toxoplasma, Rubella, Cytomegalovirus, Herpes)
serum B12 and folic acid levels (if necessary).
However, if you have had problems in your previous pregnancies, or if the parents are already having a systemic condition, more specific tests may be requested by your doctor. In this case, your pregnancy will fall into the "risky pregnancies" group.
If you have dental problems before pregnancy, it is useful to handle them in advance. Because these problems may increase with your pregnancy.
If you have problems such as hemorrhoids and anal fissures before pregnancy, eliminating these problems in advance will provide you comfort during your pregnancy.
Folic acid pills, which start approximately 3 months before conception and are used for at least the first 4 months of pregnancy, will protect your baby from a group of disorders called "neural tube defects". This is why you should take pills containing folic acid before pregnancy. Consult your physician about the use and dosage.
Before you become pregnant, make sure that you have good psychological status.
Pregnancy is not just a uterus and a baby growing in it. It is a process that will affect your mental state as well as all the systems in your body. Hormones secreted during pregnancy can make you more susceptible, tense and distress. Therefore, it is extremely important that you are ready for pregnancy and feel psychologically competent.
If you cannot become pregnant despite regular contact for at least one year, consult your physician. You may have infertility.
"Your first condition when choosing your doctor is to trust him".
The ideal for your pregnancy follow-up is that you have only one physician you can trust and experienced in. Changing a large number of physicians will have a negative effect on you. When choosing your physician, make sure that you have confidence in your knowledge and that there is someone you believe will have your birth experienced.
There will be a bond of trust between you and a physician who monitors your pregnancy from beginning to end, reducing your worries about your birth, especially during your last months.
When choosing your doctor, evaluate whether you follow the latest innovations in medicine, whether it provides satisfactory and satisfactory answers to your questions, whether you devote enough time, whether you can reach it comfortably at any time, whether the workplace is hygienic and technologically equipped.
Pregnancy Counseling
There are many important steps a couple should pay attention to when preparing for pregnancy. An important event such as pregnancy or having a child should be prepared physically, psychologically and economically. The first step of this preparation is to consult a physician. When preparing for pregnancy, a general health check and some tests are required. Because pregnancy itself can cause serious health problems in some mothers.
Doctorate Application Time
You should go to your doctor 3 months before your pregnancy. In this examination, vaginal smear, cervical culture and some blood tests can be done. These blood tests can be used to determine whether you have been immunized with vaccine-preventable diseases such as Rubella, Hepatitis-B, Toxoplasma, and Chickenpox. Since some vaccines contain live viruses (especially rubella - rubella), pregnancy should be postponed for 3 months after vaccination. At this time, folic acid and zinc can be taken to prevent some congenital injuries (neural tube defects).
Genetic Diseases
During the pre-pregnancy consultation, the doctor will question you and your family for some inherited diseases at the first appointment. If this is the case, you should seek genetic advice. If you have the same disease as your partner, you should consult your physician about pregnancy with IVF and the genetic examination of embryos.
Sexually Transmitted Diseases (STD)
Diseases transmitted by sexual contact may have affected fertility. Your physician should know if you have had this type of illness. Many sexually transmitted diseases can adversely affect the mother and the unborn baby. Diseases such as Color, AIDS, Hepatitis B are STDs that can create serious risks for the child. Although it is an ideal approach to screen all mothers for these diseases, it is not possible for economic and social reasons in general. Blood tests should be made under appropriate conditions or in suspicious situations. Mycoplasma, herpes, gonorrhea, HPV infections can also be added to STD. If one of these diseases is detected, appropriate treatment and protection measures for the child are determined.
Prenatal Vitamin Support and Good Diet
Prenatal vitamin support before pregnancy, especially taking 400 mcg of folic acid daily, reduces the disability in the cerebrospinal system. In addition to taking vitamins before and during pregnancy, the diet should be adjusted. If anemia is present, pregnancy should be recommended after appropriate treatment. Vitamin B-12 and D supplementation is important for a vegetarian mother.
Fitness and Diet
Serious weight loss diets should not be made during pregnancy. Basically, meat, milk, eggs, fresh vegetables and fruits should be consumed during pregnancy. This content can be customized according to people. In women, weight less than 15% of the ideal weight may make ovulation difficult. During pregnancy, nausea and vomiting may increase the loss of the child's development may be impaired. For this reason, women can exercise healthy diet and sports before pregnancy to achieve their ideal weight.
In addition to a balanced diet, exercises before and during pregnancy can help you give birth more easily. Exercises can be performed under professional supervision, if possible, in consultation with the doctor before and during pregnancy. Conscious exercise can be sustained, provided that you do not pant out during pregnancy. Walking without any body temperature increase, without overflowing, the distance determined by the pregnant woman can be recommended to every pregnant woman. Diving, jumping, horseback riding, skiing is not recommended. Because of the relaxation of the hormones (relaxin and progesterone) in the joints of the pregnant woman, edema and the burden of pregnancy may be easier to get hurt. Sufficient nutrition and hydration (water intake) should be continued and excessive heat should be avoided during exercise during pregnancy. Body temperature, and therefore intrauterine temperature, rotation, auger and other intensive exercise and may increase in crowded gyms. If possible, sport should be done in a ventilated, quiet hall and with appropriate clothes.
When women become pregnant, environment and habits become more important. To avoid toxoplasmosis, you should use absolute gloves when preparing food with raw meat. You should also wash your hands frequently at a picnic or in a cat environment. You should avoid meat dishes (especially "fast food") if you are not familiar with how it is cooked. If known, you should avoid exposure to asbestos dust, lead, radiation.
Bad habits
If you are addicted to alcohol, smoking or medication, you should get rid of it before you become pregnant. If you cannot get rid of these habits by yourself, do not hesitate to contact appropriate centers for professional help.
Pregnancy Planning
Marriage is a social institution where men and women agree to live together under the same roof by verbal agreement. The sense of having a child plays an important role in increasing the sharing of men and women in the continuation of marriage.
Even in our country, even newly married couples, "When is the child?" is frequently asked. These questions put the couples under pressure and continue until they are children. Being a mother and father is a really brave step. It is a very heavy process. A healthy lifestyle has a huge impact on you and your baby. With the development of the concept of preventive medicine, it became more common for people to ask for pre-marital and pre-pregnancy counseling. The main purpose of marriage and pre-pregnancy counseling is to raise the awareness of the responsibilities of the couples together, to be a parent, and to discuss what needs to be done before a healthy pregnancy and after the birth of the baby.
During our obstetrics, very few women who want to have a baby, "What should I do before becoming pregnant," he observed the doctor. But pregnancy is a phenomenon that needs to be planned.
Planning the pregnancy will help prepare you and your family for future events and will guide you through the measures to be taken. This, in addition to individual benefits, enables the generation of healthy generations with children who will be born socially at the right time and under the right conditions. As we explained about family planning, family planning should be consulted for the children who will be born at the right time and the family planning method should be chosen individually according to their specific conditions and thus pregnancy should be planned. Good health before and during pregnancy can help you overcome the social, psychological and medical problems and stresses that pregnancy can create in any situation. For this purpose, it is generally necessary to pass health checks before pregnancy. Treatments, vaccinations, preparations will help you throughout the pregnancy. Pregnancy is sometimes a problem, so it is more rational to start a pregnancy after solving your problems. After holding a healthy baby on your lap, you will forget a lot of things. But before a healthy pregnancy and the baby for yourself, especially within the rules of preventive medicine should consult with your doctor.
In this interview;
Your family life
Your medical history
Your marriage
Medications you take
Genetic problems, counseling if necessary
BMI, your nutritional status (vegetarian)
Pregnancies you have had
Your blood type
Your external care
Your vaccinations should be questioned.
Afterwards, tests should be made for diseases such as hepatitis, rubella, CMV that may cause problems during pregnancy. You should discuss this with your doctor because you may have some diseases in your family. If your family or you have problems such as diabetes, heart disease, kidney disease, epileptic seizures, high blood pressure, having a baby with mental retardation (Down Send, etc.), you should tell your doctor or let your physician ask them. The subject of hereditary diseases is another option that should be questioned in the planning of pregnancy. If the family has such inherited diseases, genetic counseling is required by a geneticist, and after a detailed family history, examination and some laboratory tests may be performed . Some of these familial diseases, especially in our country, are as follows:
Thalassemia
Tay-Sachs Disease
Sickle cell anemia
Hemophilia
Muscle dystrophy
Cystic fibrosis
Hungtington korea
Fragile-X
If you have experienced pregnancy before, their course and how it ends, the diseases that are passed are important. Although it is not absolute that this same pregnancy has occurred before, scientific studies suggest that risky pregnancies should be followed more closely. The reasons for preterm birth and recurrent miscarriages should be discussed and considered in every pregnancy. Any problems such as bleeding during pregnancy, anemia, elevated blood sugar or pressure, and albumin formation in the urine should be known by the physician. Also;
Medications you use
Whether you smoke
Whether you use alcohol or drugs
Any treatments you receive due to any illness should be questioned.
Drugs and bad habits that are queried and known to be harmful should be left before pregnancy (smoking, alcohol, drugs). The needs of a child vary depending on the rate of growth and genetic or metabolic differences. Preventing significant nutritional deficiencies is not enough for the growth and development of the child. Prevention of all short- and long-term illnesses and complete mental well-being is only possible through proper nutrition. For this, water, protein, fat, carbohydrates, macrominerals, microminerals, vitamins and flavonoids, such as all the food elements (not minimal!) And must be maintained in a sufficient condition. Adequate sunbathing, fresh air and proper nutrition are the elements that complement.
Your body mass index (BMI) should be adjusted before pregnancy. BMI in a healthy woman should be between 20-25. Maintaining an appropriate weight is an important condition for a healthy life. Trying to lose weight while pregnant or when you are thinking about pregnancy is not the right method. A weight loss diet can make you and your baby deprived of the food they need. It would be wiser to have a healthy weight before conception.
Exercise
No matter what period of your life you need a healthy diet and movement. Exercise or physical activity in which dose is reduced over time is necessary in every period of life. Read the exercise section during pregnancy about what kind of sports you will do during pregnancy. Pregnancy is the most stressful period of women's life. Pregnancy is a period in which many physical, metabolic and psychological changes occur in women. Exercise should be a part of our lives outside of pregnancy, a way of life, but if you are not exercising before pregnancy, you should not start exercising on your own.
environment
A number of substances in our environment prevent both women and men from becoming pregnant by creating some problems.
A woman who has been exposed to radiation in her workplace should determine how much radiation she has been exposed to per month before she becomes pregnant and the damages of this dose to the fetus during pregnancy should be discussed.
Heavy metals (mercury, lead), chemicals, and extreme temperatures in the environment in which we work and live may adversely affect pregnancy.
infections
Infections can harm both the mother and the fetus. Some infections during pregnancy can cause serious problems in the fetus. These tables are described in the section on virutic diseases during pregnancy. Even if you haven't been infected, vaccinated or vaccinated in childhood, you may not be immune to them at this time. If you are not immune by taking some tests against possible infectious diseases in consultation with your physician, you should be vaccinated and it is better to leave the pregnancy after immunity.
Sexually transmitted diseases may prevent you from getting pregnant and may harm the fetus during pregnancy. Since a woman trying to conceive will not use contraception, condoms have a higher risk of developing sexually transmitted diseases. If you think you have a disease that is transmitted by sexual intercourse, you should definitely consult with your doctor. In this case, your spouse should be treated and you should not have sexual intercourse until the treatment is over.
The age of the pregnant woman is important and in pregnant women younger than 18 years and older than 35 years;
Mother and baby losses
Low-weight baby birth
Problems during pregnancy and delivery are more common.
Therefore, these pregnant women should be followed by a more strict and specialist physician.
If you are planning to get pregnant at an age that is deemed to be late in terms of pregnancy, it may be difficult to get pregnant at this age if you need to consult your physician at least with FSH and E2 hormones. On the third day of your menstruation, the chance of pregnancy is decreased in the mothers whose FSH value is found to be 8-10 mIU / ml and above. As the woman gets older, some health and birth problems may increase. The risk of congenital anomaly increases at this age. Older women of course have the chance to have a normal birth and have a healthy baby, but it is important that you know the risks and assess a risk with your doctor.
Pregnancy preparation
"Of all the diagnoses a woman has received throughout her life, perhaps there is no other diagnosis that affects her life that much."
Therefore, having the healthiest pregnancy is possible by preparing yourself in the best way, both mentally and physically.
The first step and the right way of pregnancy is to design it in advance. Ideally, it is important to have a pre-interview with your doctor 3 months before the time you want to conceive. Your doctor will evaluate your medical and social history, perform your examination, perform various tests and prepare you and herself in case of abnormal conditions that may occur during pregnancy. In addition, pre-pregnancy vitamins (folic acid) with the support of the baby may take measures against disabilities that may occur.
Your doctor's examinations and examinations, as well as the treatments to be recommended, will also have things to change in your lifestyle.
You should first eat a healthy and balanced diet. Balanced diet means the consumption of the main nutrients in balanced proportions. You should reduce your consumption of fat and sugar. You should choose a protein-rich diet. Skimmed milk and dairy products, fish and white meat should be included in your diet. You should definitely take plenty of fresh fruits and vegetables, as well as pasta, rice, legumes should be consumed in different food groups such as.
If you consult your doctor before pregnancy, he or she will ask you to use folic acid for support therapy. For the development of the baby's central nervous system, it is very important to take "vitamin B9" ie folic acid, especially from the first weeks of pregnancy. It should be taken every day because it is not stored in the body, more than normal is needed during pregnancy and is not adequately met with natural foods. Fresh green vegetables are a source of folic acid, but reduce the amount of long-term cooking and long-standing foods. Spinach, peanut, hazelnut, cauliflower, wholemeal bread are mostly available. In folic acid deficiency, there are abnormalities in the nervous system called "neural tube defect" due to incomplete closure of the spinal canal. In particular, women who have previously had folic acid deficiency or who have given birth to a baby with neural tube defect anomaly should start taking folic acid at least 3 months before the date they intend to conceive.
If you smoke, you must stop. Smoking reduces the chances of conception and, when used in pregnancy, causes miscarriage and growth retardation in children. Alcohol should also be left.
You should avoid stress and anxiety. You should not stress that the occurrence of pregnancy in the first months after you have decided on pregnancy. If everything is normal, even if there is a relationship at the appropriate time, the chance of pregnancy for each month is around 25%. If a woman is unable to conceive despite normal regular intercourse, it is usually 1 year to initiate infertility investigations unless there is an obvious abnormality. Even couples without any pathology at the end of one year have a 98% chance of becoming pregnant. In other words, pregnancy may be delayed by 1 year although everything is normal in 2% of cases. Chance of pregnancy in regular menstruation 12-15. days are the most. A regular sex life and 3 or more relationships per week increases the chances of getting pregnant.
Therefore, the absence of immediate pregnancy in the first months does not mean that you or your partner has an abnormality. If you get worried about why pregnancy doesn't happen and you get stressed, stress hormones that can be released can delay pregnancy. Of course, one of the leading aims of human sexuality is reproduction and reproduction. However, you should not perceive having children as a task and you should experience your normal sexuality.
Pre-pregnancy evaluation
In prenatal counseling, the goal is "to be able to deliver a healthy baby in any desired pregnancy without any harm to the health of the mother".
Pre-pregnancy assessment begins with an interview (anamnesis). In this interview, the presence of an inherited disease in your spouse or your family; any previous illnesses or operations, whether the mother has a known condition that may cause problems during pregnancy, will be questioned. Meanwhile; Inquiries such as medications you use, smoking habits, your profession, information about your previous pregnancies (birth, miscarriage, abortion, problems that occurred during pregnancy, birth weight of babies, birth weeks, type of birth) will also give clues about the risks that may create risks during pregnancy.
After the interview, your doctor will perform a gynecological examination and transvaginal ultrasonography to evaluate the genital organs. If there are gynecological infections during the examination, the treatment will be done first. If you have not had a smear test in the last 1 year, we will recommend it. In addition, fibroids, ovarian cysts, uterine abnormalities that may cause problems during pregnancy will be investigated and if necessary, you will be advised to become pregnant after treatment is provided. Finally, your height, weight and blood pressure will be measured in order to better detect changes during pregnancy.
After the examination, it comes to laboratory examinations.
Routine tests to be performed before pregnancy:
If not previously known, the blood type of the pregnant woman and her husband (if the blood type of the mother is Rh negative, the father has blood incompatibility if the blood type is Rh positive)
* Complete blood count
* Full urinalysis
* Blood group determination (mother and father)
* Toxoplasma and Rubella (rubella) tests
* Hepatitis B carrier
In blood biochemistry, blood glucose, kidney and liver function tests are usually performed if there is a suspicious history. Your doctor may also recommend other tests (eg hormones in menstrual irregularity, thyroid function tests, etc.) if necessary to clarify the positive findings in the history.
After all examination and laboratory findings, your doctor will advise you before pregnancy.
Rubella and toxoplasmosis are infectious diseases that can cause serious problems in the baby if passed on during early pregnancy. If your rubella antibodies are negative, you are not immune to this disease, which means you are susceptible. In this case, your doctor may recommend vaccination before pregnancy. Although the rubella vaccine is made from live viruses, even if the effect is reduced, you should not get pregnant for 3 months after vaccination and check whether immunity develops at the end of this period. Negative toxoplasma antibodies are also susceptible to this disease. Even if there is no vaccine, your doctor will tell you what you need to pay attention to.
It has been shown that folic acid deficiency in the early pregnancy can lead to abnormalities in the embryological life of the spinal canal called "neural tube defect" in infants. Therefore, it is recommended to give folic acid to women who are planning to become pregnant. Your doctor will prescribe to you what dosage and how to use folic acid in the pre-pregnancy period.
Specific recommendations for problems that may arise during examination and laboratory examinations will also be provided at this stage. In addition, if not discussed in the first interview, lifestyle, nutrition, sexual life, pregnancy follow-up issues, etc. will make recommendations.
Recommended Tests Before and During Pregnancy
Deciding to have children is one of the most important decisions that people make in their lives. After making this difficult decision, it is necessary to prepare mentally and physically before becoming pregnant. It may not be enough to go to the first doctor's visit after conception. In order to have a healthy pregnancy, to have a healthy and comfortable birth and to have a healthy child, it is important to see a doctor at least 3 months before it is decided to become pregnant. The first stage of the examination is the interview. In this interview, some information such as age, occupation and number of marriages are taken first. Then, it is questioned whether there are systemic diseases such as heart disease, diabetes, liver disease, kidney disease, thyroid diseases. Gynecological and obstetric (pregnancy) history is questioned separately. In this first interview, the family histories of both the mother and father are questioned, the presence of any genetic anomaly or disease is investigated, and the genetic unit is advised to consult in case of such a condition.
After the history, general physical examination and gynecological examination are performed. If no pap-smear test has been performed in the last 1 year, pap-smear test is performed. Transvaginal ultrasonography examines the condition of the pelvic organs. Examination also determines the height, weight and blood pressure.
Routine tests before pregnancy in patients without any known disease:
Complete blood count
Full urine analysis
Blood types of parents
Toxoplasma related tests
Rubella (rubella) related tests
Tests for Hepatitis B
Fasting blood sugar
Chromosome examinations (recommended for consanguineous marriages and infants with disabilities suggestive of genetic disease)
In the presence of a systemic disease, consultation is requested from the relevant physician and the patient is followed and treated together.
Recommendations for pregnant women:
If immunity is not detected for rubella in the tests performed, vaccination is recommended. 3 months after vaccination should not become pregnant.
If diabetes is present, blood sugar should be kept under control.
Smoking or other addictions should be stopped as soon as possible
Alcohol use should be limited.
It is recommended to avoid stress as much as possible
32AXX
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