Pregnancy In The Best State of health
When we talk about family planning, we often focus exclusively on contraception. But also we can use this plan to, once we decided to go for a baby, do it with all guarantees to carry out a safe pregnancy. Of these guarantees, the main deal is to pregnancy in the best state of health. This means that whether we consider ourselves healthy women as if they have any chronic diseases or are following drug treatment, should we make a preconception consultation to serve as guidance to our gynecologist and help us to avoid the odd scare.
Let’s keep the most common: a healthy woman, with no known health problems, who decide to have a child. Since the moment you stop using a contraceptive method, “should begin to take daily folate to prevent and reduce the risk of neural tube defects in the fetus, primarily spina bifida and anencephaly,” notes Dr. Juan Luis Alcázar , Department of Gynecology and Obstetrics, University Hospital of Navarra. It is very important that folic acid taken before pregnancy, because these malformations usually occur in the first weeks after conception, just as often not even know we are pregnant.
Vaccines Review
This is mandatory, but there are other recommendations that can be very useful. Among them, perform a gynecological examination that will help us rule out certain types of diseases such as uterine fibroids, endometrial polyps, ovarian cysts … In this review, we should explain to our gynecologist who wish to become pregnant, so that we do a medical history which is reflected in our current health status: recent illnesses, treatments that we have followed in recent months, history of vaccines. .. For example, if you had doubts about whether you really are protected against rubella, a disease that causes serious birth defects, “to be checked and, if not you, should you vaccinate and wait several months before getting pregnant.
Change of medication
If in the case of healthy women except these precautions, folic acid, are only recommended, the situation changes completely when it comes to women with any chronic disease known. “In these cases, preconceptional counseling can be of vital importance,” emphasizes Dr. Alcázar. It is essential to assess the risks of pregnancy and that may change if the drug treatment that may be taking. ”
Let’s start with the drugs. Dr Oscar Martinez, head of Gynecology Hospital de Valdemoro (Madrid), explains that “there is a classification of drugs according to the security risk to the fetus, which seen from the former, as folate, which are completely safe even those who are absolutely prohibited during pregnancy, as some anti-cancer. Between the two extremes is the other drugs, most of which no trials in pregnant women contrasted enough, “and the gynecologist will value the risk-benefit . The general principle is the individualization of each case. ”
To do this, every woman in treatment should tell your gynecologist what medication follows. Thus, it can happen that hypertensive women taking angiotensin inhibitors, drugs classified as X, that is contraindicated in pregnant women. “In those cases,” says Dr. Alcázar “, your doctor should be amended to prescribe a treatment and that it is permitted in pregnant women; also be desirable to monitor before becoming pregnant to ensure that this change does not adversely affects the control of his hypertension. ”
Dangerous cases
Another drug X-retinoic acid is commonly used to treat acne, whose use in pregnancy is absolutely forbidden, said Dr. Alcázar, “because it causes birth defects. In addition, it collects in the body for a time, this teratogenic effect remains for several months after completion of therapy, months in which women become pregnant should avoid. Also, in the case of RA is also certain cytotoxic drugs should not be used, at least during the first trimester of pregnancy. ”
Even if the medications that we might be using is not contraindicated during pregnancy, we always consult with your doctor. There are many chronic conditions that require follow-up to a certain treatment, and may well have to adjust the dose, is something that happens frequently in hypothyroidism, and that pregnancy favors lower levels of thyroid hormones.
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