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Providing counseling to the expectant mother before pregnancy has measurable positive effects on the outcomes of pregnancy. When the effects of pre-pregnancy examination on pregnancy were taken into consideration, it was emphasized that this would be the most important public health service alone.
To investigate the presence of chronic disease in mothers;
Diabetes (diabetes): The high blood sugar level of the expectant mother causes serious problems both for the mother and the baby to be born. If the glucose level is controlled and attempted pregnancy, the problem will disappear. In such cases, blood sugar should be monitored before pregnancy and normal values should be obtained and HgA1C level reflecting the sugar status of the last three months should be observed to be normal. The most risky period for the fetus in diabetic patients is when the first formation of the fetus called yolk sac is detected. Being late may cause distress. Diabetic mothers are more likely to be at risk for high blood pressure than normal cases. Pregnancy should not be allowed in mothers whose diabetes affects the kidney to a great extent.
Epilepsy (epilepsy) disease: Epilepsy seizures tend to increase during pregnancy. This is related to the physiology of pregnancy, as well as worrying about stopping the drugs because of the harm to the baby to be born. This problem is solved by changing the drugs before the pregnancy and giving them at the lowest possible dose. In general, the drug can be discontinued in patients who take a single drug and do not have seizures for at least 2 years. The use of folic acid in these patients should be particularly emphasized.
Hypertension:It deteriorates during pregnancy and seriously affects maternal health. Before pregnancy, the expectant mother's kidney and heart health should be tested. Sometimes the weight loss of the expectant mother should be encouraged as correctable measures. The use of antihypertensive drugs containing angiotensin converting enzyme is never allowed in patients who are planned to have pregnancy. Blood pressure should be controlled with safer drugs during pregnancy.
Kidney disease: In pregnant woman, the addition of a severe condition called preeclampsia to hypertension due to dysfunction of kidneys is of concern. Renal function deteriorates very quickly in patients with serum creatinine greater than 2 mg / dl. The same worrisome developments affect the baby.
Heart disease: If there is congenital heart abnormality in mothers, this risky situation is evaluated according to the condition of the case. For example, cases with aortic coarctation and pulmonary hypertension are at high risk. Cyanotic heart disease cases are at the highest risk group. They should not conceive.
Connective tissue diseases: Systemic lupus, rheumatoid arthritis, ankylosing spondylitis, scleroderma are among these diseases. These autoimmune diseases can cause problems from minimal to life-threatening degrees. Only rheumatoid arthritis shows improvement during pregnancy. Candidates should be informed according to the degree of their illness.
Psychiatric disorders: The risk of severe postpartum depression and psychosis is high, especially in cases with pre-existing psychological disorders. Those with major psychological symptoms should consult a psychiatrist before becoming pregnant.
thrombophilias : Pregnant mothers in this group have a high risk of developing a spigot. This is both risky for maternal health and may cause developmental delay, premature birth and miscarriage loss in the newborn. Pre-pregnancy counseling is very important for these expectant mothers and it will be possible to prevent this situation by taking precautions.
Genetic diseases: Congenital defects are still the cause of 20% of newborn deaths. Of these, the so-called neural tube defect, the spine remains open, and the organs of the nervous system remain exposed in the unprotected, both for families and the newborn begins a difficult and sad process. It should be given. Folic acid should be increased to 4 grams per day, especially if the mother has a history of this.
Phenylketonuria: It is a congenital metabolic disease. It is not hereditary. If the mother candidate is phenylketonurylated and has not done her diet, this will affect the baby very seriously.
Thalassemia: Today, 250 million people in the world carry the hemoglobinopathy gene with blood disease. Especially because it is widespread in the Mediterranean countries, mother and father candidates should be screened and informed in this respect.
Another important issue is the immunization of the candidate mother against hepatitis b and rubella before pregnancy.