For The Mothers-To-Be
By Dr Tan Thiam Chye, Consultant, Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital. Assistant Professor, Duke-NUS Graduate Medical School.
Being well prepared would optimise your chance of a smooth pregnancy and healthy baby. It prepares your body, both physically and emotionally. You have decided to embark the journey of motherhood. Congratulations! Let’s see how you should get yourself prepared for a healthy pregnancy.
Visit a gynaecologist to discuss on your chance of conception, previous medical problems that may affect your pregnancy, family history of genetic problems and immunisation history. Your check-up may include a PAP smear test, thalassemia (genetic blood disorder) test and rubella (German measles) screening. A pelvic ultrasound scan can also be performed to check for ovarian cysts or fibroids in the womb.
It is important to take a diet balanced in calories, carbohydrates, proteins and fibre. Folic acid is a type of vitamin B that is needed for the formation of blood cells and the development of baby’s nervous system. It has been shown to reduce the chance of a baby having neural tube defects (spinal cord and brain abnormalities). A simple way is to take a folate supplement of at least 800 μg for 3 months before conception and continue till the first 12 weeks of pregnancy.
Optimise your medical conditions
Controlling your medical conditions such as diabetes mellitus and hypertension improves the prognosis for you and your baby. Consult your obstetrician early as pregnancy could be complicated with such medical conditions. If the medical conditions are well-controlled before you conceive, you are more likely to have a smoother pregnancy and a healthy baby. Other existing medical conditions that could affect or be affected by pregnancy include:
• Auto-immune diseases such as Systemic Lupus Erythematosus and Rheumatoid Arthritis
• Thyroid disorders
• Anaemia such as iron-deficiency anaemia or thalassemia
• Kidney Disease
• Heart Disease
• Deep Venous Thrombosis or Pulmonary embolism (blood clots in legs or lungs)
It is possible to have a successful pregnancy if you have one of these chronic conditions, but it may be considered a high risk pregnancy and you will have to take some special precautions. If you are on chronic medication for these conditions, your gynaecologist will want to assess them in terms of their effect on you and your developing baby. For example, if you are a known diabetic on oral medication, you will need to change to insulin injections once your pregnancy is confirmed.
Avoid high-risk activities
It is advisable to stop smoking. Substance abuse and smoking are associated with miscarriage, slowing of baby’s growth in the womb, pre-mature delivery and bleeding in the placenta. Avoid excessive alcohol intake and binge drinking. This can lead to congenital malformations and mental impairment of your baby.
Maintain a healthy diet and lifestyle!
The prime of your fertility is between 20 – 24 years old with a sharp decline from 35 years old onwards. On average, there is a drop of 3% in fertility with each increasing year of the woman’s age.