Preconceptional Care is a new conception in obstetrics that originates from the value that prevention has acquired in modern medicine. Historically, the beginning of medicine only addresses illnesses and barbaric attempts to obtain healing, progressively and over the centuries the knowledge is increasing and healing procedures are improved while we begin to understand the origin of diseases and why and those who produce them. By knowing the cause, you can prevent the disease, stop or mitigate its effects.

Prevention suggests an important medical advancement that goes beyond the exquisite therapeutic advances of current healing medicine and, in addition, is usually more economical and less traumatic for the patient. Prevention is about us remaining people and not reaching the category of patients.

Traditional obstetrics began when the woman had months of menstrual delay or worse, when she had the pains that preceded childbirth. Without pregnancy tests or ultrasound, it was necessary to determine if the abdominal growth was a tumor or a baby. When the ultrasound appeared you could see patches that supposedly represented the baby: with time those patches were improving in quality (thanks to the technological advance) and now we can see images as beautiful and detailed as those that abound in this website.

Even when we can not modify the product of conception, at least in a natural way, we can avoid the effects of maternal diseases on it and improve the reproductive prognosis of the couple

What is done in preconception control?

In general, it is a usual gynecological consultation where the patient refers to planning a future pregnancy. The doctor makes a clinical history with special emphasis on risk factors, habits and diseases that could complicate pregnancy in maternal and fetal terms and suggests strategies to control or eliminate them

Strategies indicated in preconception control and its benefits

1. Folic Acid Intake: It has been shown that patients who take folic acid at least one month before being pregnant significantly limit the risk of Spina Bifida and its variants. The recommended dose for patients at risk (personal or family) is 4 mg per day, but as folates do not generate side effects and in many places there is no presentation of 4 mg we usually use a dose of 5 mg daily even before absence of risk factors. The daily dose approved by the FDA is 0.4 mg if there are no risks but we treat everyone as if they had it. If we were to find any contraindication, we would immediately suspend this action but until now it does not exist and we must remember that Venezuela is a country with a high rate of malnutrition (as are many countries in the world)
2. Vitamin D intake: I am considering the daily use of at least 1000 IU of Vitamin D , since according to current reports its deficiency is very frequent even in countries of the tropics with high solar exposure. The daily dose will be adjusted according to their plasma levels (VN 40-60 ng/mL). For the current standard it is estimated that the adequate dose for an adult is approximately 6000 IU per day.
3. Multivitamins: Recent studies suggest that starting prenatal multivitamins 3 months before pregnancy reduces the risk of nausea and vomiting during the initial stages of pregnancy. Also, they can correct some hidden deficits
4. Omega 3 intake : Fish oils (decosahexaenoic acid) used before pregnancy or from its early stages may be beneficial in the prevention of preterm delivery and fetal growth retardation, print a greater maturation of the fetal central nervous system and is possible to help correct the adverse effects of maternal hypertensive problems.
5. Exercise physically: According to recently published medical articles, physical exercise before and during pregnancy not only improves the physical conditions and the sensation of maternal well-being, but also brings short, medium and long-term benefits to the fetus and the future infant. I recommend reading my article published in this site: Exercise and pregnancy where you will find a complete review on this topic.
6. Eliminate the use of tobacco and cigarettes: The elimination of the cigarette from the life of the pregnant woman is essential. There is no room for maternal selfishness when smoking during pregnancy can alter the fetal circulation and the supply of oxygen and nutrients from the mother to the fetus. Smoking & Pregnant? Leaving aside the potential harm to your baby, your risk of dying from cardiovascular complications is much greater. Especially after 35 years. In another article You can find the decalogue of the things you should not do during pregnancy.
7. Suspends the use of alcohol: alcohol causes a sad fetal picture and the newborn known as Fetal Alcohol Syndrome characterized by congenital malformations and intellectual disorders and psychomotor development.
8. Leave the drugs: if you are a user of recreational drugs (cocaine, heroin, crack, amphetamines, marijuana, etc.) seek help and make a sublime effort for your future baby, do not make him prone to congenital malformations, to die inside your uterus, to be small and disabled. Do you need more explanations?
9. Actively get involved and control your chronic diseases: it is your responsibility in life (and your future) to adequately control the chronic diseases that afflict you. I will mention only two because of its frequency, importance and possibility of control. Diabetes : it is known that uncontrolled diabetes leads to maternal complications before and after pregnancy (if it reaches a successful conclusion) but it is that uncontrolled and long-standing glycemia leads to frequent and severe fetal malformations; Adequate control of glycemia for at least 3 months before pregnancy limits the adverse effects of diabetes on the fetus (and naturally on the mother). Hypertension: hypertensive patients have a greater number of maternal-fetal complications than their healthy counterparts; of them we can mention some as preeclampsia, fetal growth retardation, prematurity, placental detachment, emergency cesarean section, maternal and fetal death. Any chronic disease that precedes adequately controlled pregnancy improves the maternal-fetal prognosis. A greater exposure on diabetes, hypertension and pregnancy can be found by following these links: Diabetes , Preeclampsia and Hypertensive and Pregnancy
10. Know your viral infectious status: Ask for viral tests to see if you are immune or not. The most important is Rubella because if you have not suffered from it during pregnancy, its effects on the baby are devastating. If negative, you will be vaccinated but you must wait 3 months before getting pregnant.
11. Plan your economy: it is convenient to establish a small savings fund for expenses that immediately involves the birth of a baby and immediate attention: pediatrician, vaccines, diapers, medicines, milk. If pregnancy is not a close thing, establish a fund in hard currency that does not suffer devaluation: dollars or euros, for example.
12. Purchase Maternity Insurance that includes your baby at birth: or check what type of insurance covers you in your job. Keep in mind that personal insurance can not be used for maternity until after 11 months of contracting the service, this means that you have to pay at least 2 years of hospitalization, surgery and maternity insurance for you to have coverage during the birth of your baby. If your baby is going to be born in a public hospital, be sure to evaluate the best possible option in terms of care and resources.