Pregnancy and Birth › Pre-Conception Assessment
Pre-Conception Assessment
Much of what can be done in pregnancy is in fact what can be done before it. A pre-conception assessment allows the factors affecting the baby's development in those first weeks to be addressed before conception has occurred.
When to come
As soon as pregnancy is being considered, and preferably at least three months before it is planned. That interval allows folic acid supplementation to take effect and any problem found to be corrected.
What is assessed
- Menstrual pattern and ovulation
- Previous pregnancies, miscarriages and operations
- Ongoing conditions: hypertension, diabetes, thyroid disease, epilepsy
- The safety in pregnancy of medication being taken
- Family history and the risk of inherited disease
- Smoking, alcohol and weight
- Immunisation status (rubella, hepatitis B, chickenpox, tetanus)
Tests requested
- Full blood count and iron level
- Blood group and assessment of Rhesus incompatibility
- Thyroid function (TSH)
- Fasting blood glucose
- Rubella immunity
- Screening for hepatitis B, hepatitis C, HIV and syphilis
- Vitamin D level
- Screening for thalassaemia where indicated
Folic acid
Folic acid substantially reduces defects of brain and spinal cord development in the baby. It is advised from at least one month before conception and throughout the first three months.
A higher dose may be required after a previous pregnancy affected by a neural tube defect, in diabetes, or when certain medications are taken; that decision is made at the assessment.
Women with ongoing conditions
Conditions such as diabetes, hypertension, thyroid disease or epilepsy should be stabilised before pregnancy. Some medications need to be changed to alternatives that are safe in pregnancy — a change to be made under medical supervision, never on your own.
