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Going to a preconception consultation is essential when planning a pregnancy. Assessing the mother's health status is essential before becoming pregnant. Most health problems in women can be solved before conception and others can be prevented to ensure the best possible health during pregnancy.
The doctor Antonio González, head of the Obstetrics and Gynecology Service of the La Paz Maternal and Child Hospital, from Madrid, explains what are the precautions that we must take into account before getting pregnant.
How far in advance should we plan a pregnancy?
Planning always brings a benefit to both the mother and the future baby. There are a series of preventive measures, which affect the health of both, and one of them is the contribution of folic acid. It is advisable that when the woman becomes pregnant, she has already taken some time, two or three months, taking vitamin supplements that will be favorable for the development of all the baby's devices and systems.
What disorders does folic acid prevent before pregnancy?
There is a causal relationship between folic acid deficiency and some neural tube malformations such as spina bifida. Taking folic acid three months before conception is a preventive measure to prevent the baby from developing a neural tube defect such as spina bifida. It is recommended that all women are already taking folic acid when the pregnancy arrives.
What should we take into account before starting sexual intercourse to get pregnant?
Living a healthy life with healthy habits is important for all women, especially those who already have a disease such as heart disease, diabetes or a history of these disorders before planning pregnancy.
For this reason, we direct these future mothers to the preconception consultation, where we give them a series of advice, in addition to exploring them and seeing if the disease is well controlled, so that they can support a future pregnancy.
Can the preconception consultation also advise against pregnancy?
In the preconception consultation we give practical guides and advice for a future pregnancy. But, from time to time, we receive patients who already have pathologies, which after analysis and relevant tests, make pregnancy inadvisable and the advice is to wait a season to become pregnant.
How long to wait and why do it?
Mainly to start the pregnancy in good health. A woman who is hypertensive, diabetic or has a hematological problem and is not well treated should not become pregnant until, after appropriate treatment, she has managed to adjust her disease.
The preconception consultation not only helps a woman to become pregnant, but also serves to direct her health and advise against pregnancy when the situation is serious or allows a balance or improvement in her health with appropriate treatment.
What advice would you give to women who choose to be late?
The maternal instinct is so strong that the recommendations that limit it are often ignored by the interested party. But, there is no doubt that pregnancy has an age. The further one is over 35, the greater the risks. The oocyte, which is the female cell, with age their quality worsens and the risk of chromosomatopathies (chromosome alterations) increases with age.
This can lead to malformations such as Down syndrome or trisomies. But also, as we get older, more diseases appear and it is easier for a woman to develop kidney disease, hypertension, heart or infectious disease.
Does the advanced age associated with pregnancy also have risks in childbirth?
Around age 40, dilation and distention of the perineum is more difficult. It is true that we have achieved a medicine that favors pregnancies at this age and this is an achievement.
Nor can we ignore the problems inherent to age and, in this sense, the number of cesarean sections after 40 years is much higher than between 20 and 30 years because the dilation is slower and more difficult and, being longer , the baby is more at risk. We are now going through a stage of medicine where safety prevails and we have to ensure that a child is born well from the physical and mental point of view.
In the case of hereditary diseases, what controls are necessary to avoid them in future children?
The most important of all is genetic counseling. To do this, it is convenient to determine, first, what disease it is, and second, what possibilities it has of being inherited. They should be studied and known before pregnancy to offer advice to the patient or advise against pregnancy, in the event that we cannot prevent it from being transmitted from parents to children.
Head of the Obstetrics and Gynecology Service
La Paz Maternal and Child Hospital
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