About 75% of pregnancies occur unplanned.
Some women have successful pregnancies, and some have complications that could have been avoided if the parents had started preparing in time. Careful preconception preparation makes it possible to assess the state of health of future parents and will increase the probability of a normal pregnancy and the birth of a healthy child.
What needs to be adjusted before pregnancy?
- Correction of lifestyle and eating behavior.
- Restoration of nutritional deficiencies (iron, magnesium, folic acid, vitamin D).
- Rehabilitation of chronic foci of infection.
- Examination of somatic status and consultation of specialized specialists.
- Examination and treatment (if necessary) of the partner.
Where do we start?
3-6 months before the planned pregnancy, the couple must completely give up alcohol and smoking. Yes, couples in particular, because the habits listed above, greatly worsen the qualitative and quantitative composition of sperm.
Smoking affects the peristalsis of the fallopian tubes, as well as the mucus in the cervical canal. It becomes more viscous and it is more difficult for spermatozoa to penetrate the uterus. Smoking has a direct harmful effect on reproductive cells, so the probability of spontaneous abortions and ectopic pregnancies increases. Smoking leads to premature exhaustion of the ovarian reserve and premature aging of the ovaries.
Nutrition is important!
It is necessary to give up fast food, exclude from the diet smoked products, semi-finished products and products with a significant content of stabilizers and preservatives. Preference should be given to vegetables and fruits.
It is important to consume food rich in folates and B vitamins. Food sources of folic acid are found in cereals and their processed products (wholemeal flour, bread and bakery products made from this flour, buckwheat and oat groats), and beans are also rich in their content, soybeans, cauliflower, lettuce, spinach, green onions, mushrooms, liver, cheese, caviar and eggs.
Healthy and proper nutrition will strengthen immunity and significantly improve well-being.
Get rid of extra kilograms.
Numerous studies have proven that the normal body weight of future parents increases the chance of having a baby. In addition:
- Normal body weight increases the chances not only for pregnancy, but also for the possibility of giving birth to a healthy child.
- The presence of extra kilograms has a negative effect on the quality of egg cells and sperm.
- Obesity can cause erectile dysfunction and affect male and female libido.
- Being overweight can cause problems with hormone levels that can affect a woman's menstrual cycle.
One of the options for measuring whether you have a normal weight is to use the body mass index. Body mass index is calculated by dividing body weight (in kilograms) by the square of height (in square meters).
For example, we determine the body mass index for a person who weighs 65 kg with a height of 170 cm. BMI = 65/1.7*1.7 = 22.5.
Next, we compare the obtained indicators:
- BMI less than 18.5 indicates underweight.
- 18.5-24.9 — the equivalent of normal body weight.
- 25.0-29.9 — indicates the presence of excess weight.
- More than 30.0 is a sign of obesity.
Folic acid.
According to WHO recommendations, taking folic acid (FA) before pregnancy (for 2-3 months) and during pregnancy (at least the first three months) in the amount of 400-800 mcg/day prevents not only neural tube defects, but also abnormalities of brain, cardiovascular system, urinary system, cleft palate formation, limb defects and umbilical hernias.
Since most pregnancies are unplanned, the American Institute of Health advises all women of childbearing age to take FC at a dose of 400 mcg/day continuously, and for women who have a history of neural tube defects and are planning to give birth, 4 mg/day. A child receives 50% of the genetic material from his father, so his body should be saturated with vitamins and folates. Folate improves sperm condition. Every 100 mg of folic acid, taken by a man at the stage of pre-gravid preparation, reduce the number of abnormal spermatozoa by 3.6%.
Effect of vitamin D
Vitamin D plays an important role in the functioning of the human reproductive system. Receptors for this prohormone are found in all female reproductive organs, including the ovaries, uterus, placenta, hypothalamus, and pituitary gland.
The role of vitamin D for women planning pregnancy:
- has a positive effect on the probability of occurrence and development of a healthy pregnancy;
- affects pregnancy, reduces the risks of miscarriage;
- has an effect on the treatment of infertility.
According to the conclusions of a study published in 2018 in the authoritative journal The Lancet:
- 53% of women have vitamin D deficiency,
- women with sufficient levels of vitamin D have a 10% higher chance of becoming pregnant compared to those who are deficient.
(1191 women with a history of reproductive loss participated in the study).
Early consultation with a doctor and following the recommendations will help eliminate vitamin D deficiency, if present.
Examination of an obstetrician-gynecologist.
Of course, the main point in preparing for pregnancy is visiting a medical center, where you will be examined, examined and consulted.
You should start with an examination by an obstetrician-gynecologist to plan pregnancy management with a mandatory colposcopy and swabs for microflora and oncocytological examination.
It is also necessary to undergo an ultrasound examination of the pelvic organs to exclude pathological processes and to determine the state of the reproductive organs. A number of laboratory tests should also be performed.
TORCH-infections.
Examination for TORCH-infections is mandatory. After all, it is impossible to know for sure whether you had rubella or not. Parents do not always have this information, as rubella is often disguised as a banal SARS or vice versa. More accurate information can be obtained only from a blood test for the detection of antibodies.
A quantitative analysis is carried out to determine the titer of antibodies – antibodies to rubella, herpes, toxoplasma, cytomegalovirus.
- The presence of IgG antibodies means developed immunity to these infections and is not an obstacle to pregnancy.
- The presence of IgM means an acute stage of the disease, pregnancy planning with such an analysis result should be postponed until complete recovery.
- If there are no IgG antibodies to rubella, you must be vaccinated and then take precautions to prevent accidental pregnancy for 3 months.
The insidiousness of the virus lies in the fact that when it enters the body of a pregnant woman, it passes through the placental barrier and infects the fetus, which subsequently leads to congenital malformations.
It is also necessary to visit a therapist. The doctor will examine you, evaluate the general condition of the body and readiness for future loads. If chronic diseases are detected, he/she will refer you to narrow specialists. Perhaps he/she will recommend an examination by an endocrinologist, neurologist, geneticist, etc. It is important to discuss the issue of vaccination against diphtheria, rubella, and COVID-19.
You should not postpone a visit to the dentist to assess the condition of the oral cavity. It is known that the condition of the teeth deteriorates during pregnancy. Therefore, do not be lazy to visit the dentist, even if you have no complaints. It is necessary to undergo an examination and, if necessary, professional hygiene. If necessary, take an X-ray, because after the onset of pregnancy, all irradiation will be prohibited.
Planning a pregnancy increases the chances of its healthy course and the birth of a healthy child! Choose your doctor and make an appointment for a personal consultation to clarify all questions.
Author of the article: Olha Dovhaniuk, obstetrician-gynecologist of the first qualification category.
