Thursday, November 15, 2012

Risks of preconception

Risks of preconception
Preconception, as well as during pregnancy is a very important part of pregnancy care issues. Unfortunately, this period is often ignored, especially considering that a fairly large percentage of pregnancies are unplanned, unexpected or occur in poor environments, without access to information and specialized medical services.

About care and counseling during the preconception period
Preconception refer to those interventions aimed at identifying and modifying risk biomedical, behavioral and social Associated woman or pregnancy / baby, child further development and management of these risks (prevention, treatment, control, optimization of health).
Preconception preconception evaluation and counseling enables women to be informed about pregnancy fertility problems, identify certain factors harmful to the mother, fetus and educate themselves on the risks associated with pregnancy, appropriate interventions (when possible) before conception of a child. To prepare the preconception period is to assess both the risks surrounding the woman who wants to conceive and risks to the fetus if a woman becomes pregnant.

Doctors recommend women go to a medical examination preconception when they decide to conceive a child - best of 3-6 months before trying to conceive. This margin allows time to prepare physically and mentally for fertilization, wearing pregnancy and childbirth, giving greater control over their santatati and child.
Investment of time, energy and attention to possible problems during the preconception pregnancy has great benefits to the mother and developing fetus.
Optimize the health of the mother (and father of the future) before pregnancy is important to improve the outcome of conception. This is especially true for women with various medical disorders (diabetes, phenylketonuria, etc.), nutritional deficiencies (lack of folic acid and vitamins and nutrients necessary for normal development of the fetus), and teratogenic exposure to harmful substances (cigarettes, alcohol, isotretinoin).
Risks of preconception
Preconception care is sometimes more important than prenatal care in preventing birth defects and certain difficulties of the task, considering that about 30% of women begin their prenatal care in the second half of pregnancy (over 13 weeks) which is after the period of organogenesis (organ formation during the first 3-10 weeks of gestation).

During the design so the couple / the mother and the physician should consider the following issues need to be addressed explicitly and attention:
* Education:
- Tobacco, alcohol and other illicit drugs, the abuse of certain drugs;
- Consumption of folic acid - preconception and prenatal care standard;
- She has to take medication required strict doctor's recommendation and notify him if accidental or voluntary consumption of any drug;

* Advice:
- STDs;
- Family planning;
- Weight control (balanced, healthy) diet;
- The importance of oral health (dental health and oral cavity);
- Genetic disorders;

* Evaluation:
- Own family genetic history and future father: ethnicity (no genetic diseases that occur more frequently in people of a certain ethnicity), existing diseases in the family;
- Medical history and physical examination - identifying potential problems and treatments influence on the body or fetus;
- History obstetric device: miscarriages, abortions, premature births, preeclampsia, pregnancy stopped progressing, cesarean, etc.
- Gynecological history (diseases, surgery, gynecological treatments);
- Status of health and medicine (clinical and biological evaluation during the preconception and determine the extent to which certain maternal diseases or certain drugs that it can affect the fetus);
- Immunization history;
- Complications of previous pregnancies (gestational bleeding, postpartum hemorrhage, thrombotic events, preeclampsia, eclampsia, gestational diabetes, Rh incompatibility);
- Identification and assistance for victims of physical abuse, sexual (women subjected to any form of abuse and domestic violence in the preconception period are at risk of preeclampsia and preterm delivery);
- Psychosocial and behavioral skills to determine whether the prospective parent is prepared for this responsibility, care and protection abilities, can provide a stable home child communication identifying deficiencies, depression, anxiety, excessive stress, chronic fatigue, etc..

Risks preconception
Not an exhaustive list these are the main risks that a couple has to take into account the preconception period (to ease the discomfort of pregnancy or pregnancy difficulties prevent problems during pregnancy).
Risk categories during the preconception:
*** Behaviors: alcohol abuse, smoking, drug abuse, domestic violence, nutrition - nutrition, food supplementation with folic acid, administratarea drug (doctor only), previous pregnancy loss, psychological concerns;
*** Chronic diseases: asthma, diabetes, heart disease, hypothyroidism, obesity, diseases parodoantale;
*** Gene: cystic fibrosis, phenylketonuria, maternal anemia, sickle cell;
*** BTS: Bacterial vaginosis (variation of vaginitis), chlamydiosis, gonorrhea, heptatita B, heptatia C, HIV, cervical cytology (Pap test to prevent cervical dysplasia and cervical cancer), syphilis, etc.;
*** Immunization - Preconception vaccination: HPV, influenza, rubella, chicken pox, etc.
*** Risks related to maternal lifestyle:
- Recommended regular exercise, moderate (physical abuse, physical exercise can lead to infertility);
- To avoid hyperthermia (hot water);
- Attention to obesity and weight control;
- Risks associated with nutritional deficiencies especially in vegetarienelor, women who suffer from lactose intolerance, calcium and iron deficiencies;
- Avoid abusive consumption of vitamin A, vitamin D, and caffeine during the preconception;
- Identification and assistance for social problems: homelessness, inability proper child care, etc..

Early recognition of potential problems and their improvement during the preconception can radically alter pregnancy outcomes.
Risks of preconception
>> Lack / insufficiency of folic acid
Consumption of folic acid is required for pregnancy and fetus (provide training and healthy cell growth) - reduces the risk of heart attack, stroke, cancer and diabetes for the mother and the risk of developing a severe neural tube defect in children (a birth defect involving incomplete development of the brain and spinal cord) by more than 50%. Consumption of folic acid at least one month before conception and during the first trimester of pregnancy prevent neural tube defects and spina bifida in children (column as malformation rupture due to incomplete development of the neural tube or bones what it covers).

Rh incompatibility >>
Making preconception of blood group and Rh factor from both parents - very important to evaluate the risk of Rh incompatibility. If the mother is Rh negative and the father Rh positive, necessary after the first pregnancy (carried to term or not, miscarriage or on request) to make dosing of antibodies to Rh positive gene (in max 72 hours) to avoid their training in the mother's body for Rh positive gene, antibodies that destroy red blood cells (red cells) child only if the child inherits the father's Rh positive) (if the child inherits the Rh-negative mother if the mother is Rh positive or both parents have Rh negative - it is not incompatibility). Even in this case there are treatments for the baby during pregnancy and after delivery in order not to endanger the child's life (phototherapy and blood transfusion).

Maternal Obesity >>
Side effects associated with maternal obesity: neural tube defects, premature birth, diabetes, hypertension and thromboembolism. Weight control, weight loss and stabilization before conception significantly reduces these risks.

Alcohol >>
Alcohol is completely forbidden during pregnancy and the preconception period - true effects of alcohol consumption during this period - fetal alcohol syndrome involving neurological disorders, hearing defects, poor growth, mental retardation, central nervous system disorders, cranial malformations -specific facial (craniofacial dysmorphism), neurobehavioral consequences, etc..

Eating >> anti-epileptic drugs, many with teratogenic (causing birth defects, abnormalities).

Smoking >> preconception period and during pregnancy
Risks ectopic pregnancy, miscarriage, premature birth, low birth weight of the child (physical underdevelopment), premature rupture of membranes, nounascutului sudden death syndrome and other diseases acquired as a result of developments in an adverse environment.
Since only 20% of women can control their nicotine addiction during pregnancy, it is important that this defect to be removed before you decide to conceive. Being pregnant without knowing, seriously harm your child's health in its first months of development. Try to stop smoking without the use of nicotine replacement therapies since and they will expose the fetus to nicotine and its negative effects.

Drug >>
Drugs are bad for your health whether or not pregnant, much more as a baby grows inside your body and you felt any action on the body. The risk of miscarriage or premature birth increases significantly as the child's birth weight too low (with negative effects on mental development, cerebral palsy affecting motor function and coordoanre movements), hemoragiii brain acquisition of STDs and hepatitis B, C).

Administration of oral anticoagulants >> - teratogenic in both pregnancy and the preconception periaoda.
Administration of isotretinoin >> as treatment for acne can cause miscarriage or birth defects.
Periodontal diseases >>
There are studies proving the link between periodontal disease and its effects on pregnancy: preeclampsia, fetal low birth weight, premature.

Risks associated with exposure >> (even random) to radiation and chemicals
If you are trying to conceive you must make it a habit to read the warning labels on products containing chemicals you use for cleaning, disinfecting, etc.. Also making environmental exposure to various chemicals, radiation, infection affects DSVSA and fetal health. While employer must communicate your decision to conceive a child and he is forced to reduce as much as possible the harmful influences of the work environment.
Risks of preconception
Risks >> conception / birth of a child with inherited disease
Some health problems are inherited, that are transmitted by genes inherited by the child's parents. Eg sickle cell anemia (red blood cells take the form of a sickle - shaped nefvorabila oxygen transport and circulation through the blood vessels), cystic fibrosis (prevents digestive system and lungs to function normally, disrupting the normal functioning of epithelial cells that form the skin and sweat glands ways passage to the lungs, liver, pancreas and the digestive and reproductive systems), Huntingdon's disease (which slowly deteriorating brain) etc.
Before you decide to get pregnant (if you know the history of inherited diseases in the family, there were problems with tasks gene family) you should get your first blood test and then will be assessed risks of transmission of hereditary diseases.

>> Risk of HIV infection (AIDS)
Identification of human immunodeficiency virus present before conception offers the chance to control symptoms with the administration treated women (couples) in order to keep control of the devastating action of the virus (incurable). You also need to be prepared physically and mentally to bring a child into the world who have this virus and to take responsibility conception, birth and growth of (with all its special needs).

Sexually Transmitted Diseases >>
The fetus transmission of STDs from one parent can cause fetal death or physical, mental or substantial development (including loss of motor skills, mental disabilities, blindness, etc.). Chlamydiosis (Chlamydia) and gonorrhea are often associated with ectopic pregnancy (ectopic), infertility or chronic pelvic pain.

Diabetes in preconception >>
Need to take some precautions during preconception that diabetes does not affect the future health of the woman and fetus: continuous monitoring of the health of the mother and pregnancy management is effective in controlling diabetes. Whether you have type 1 or 2 diabetes with proper care and treatment you can prepare for future pregnancy only after consulting a doctor.
Risks miscarriage, birth of a baby heavy, congenital malformations of the fetus.

Vaccination of preconception >>
Not recommended vaccinating pregnant women in the last 4 weeks of preconception with vaccines containing live attenuated (dead virus vaccine inoculated in) - there is a risk of developing a disease.
In preconception screening is recommended to perform a certain communicable diseases preventable by vaccination: rubella, hepatitis B, measles, heptatita A, mumps, chicken pox, etc.. They make some tests for women's diseases: toxoplasmosis (which generates growth problems, blindness, brain damage, epilepsy and deafness), mole (without embryo pregnancy - develops only placental tissue), etc..
Prevention of hepatitis B for a woman who wants to conceive a child reduces the risk of infection and eliminate risks that endanger their health and lives (liver disorders, liver carcinoma, cirrhosis, death).
Potential vaccines in preconception (contraindicated during pregnancy) live attenuated influenza, measles, mumps, rubella, live attenuated polio.

Risks of preconception
High risks for both the mother and child for the future are subject to unplanned pregnancy, unwanted or recommended by your doctor, especially during the first weeks of pregnancy when the mother knows she is pregnant. Also lack of medical tests prior fertilization, pregnancy to determine the health of the mother and if he can lead a healthy pregnancy to term, chronic or acute maternal hereditary disease can complicate pregnancy and can endanger the lives of the two.
Medical examination and care from preconception preconception can diagnose / improve in time certain conditions and can evaluate the possibility of complications during pregnancy. Asmenea knowledge of any information and medical recommendations eliminate unnecessary stress and any worries during pregnancy.

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