《Popular Science Classroom》
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Health science expert
Tian Jiayi
Attending physician of the Reproductive Prenatal Genetics Center of the First Hospital of Jilin University
Eight-year Ph.D. from Jilin University
#今日科普话题 #
How to eugenics and health good "pregnancy"
Now couples need to prepare for pregnancy before pregnancy, and pregnancy preparation is to better get pregnant and ensure the health of the fetus. Therefore, there are many things to pay attention to in the early stages of pregnancy, such as the physical health of men and women, diet and rest habits, and changes in mood. Therefore, couples should prepare for pregnancy before pregnancy, and prepare for pregnancy. So what do you need to pay attention to during pregnancy preparation? What routine tests do I need to supplement what nutrients?
Today we invite experts to popularize the relevant content before pregnancy.
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Hello Dr. Tian, what are the necessary tests we need to do before pregnancy?
Before preparing to conceive the baby, both husband and wife should undergo the necessary physical examinations, including urine routine, blood routine, liver function, etc., the most important of which is the reproductive system, genetic history and immune system examination. Especially in the case of marriage tests not fully covered, pre-pregnancy tests are particularly important, and standardized pre-pregnancy tests can help expectant mothers conceive a healthier baby.
The goals of preconception testing are:
Identify potential risks to the mother, fetus, and pregnancy.
For these risks, risk-reducing interventions and treatment options and fertility alternatives are adopted.
Initiation of interventions to obtain optimal maternal, fetal and pregnancy outcomes.
1. Reproductive system examination
The main items of the reproductive system examination are routine screening for vaginal discharge, trichomoniasis, gonorrhea, syphilis, vaginal inflammation test, mycoplasma and chlamydia infection testing. The purpose of this test is to determine whether expectant mothers have various gynecological inflammatory diseases. If expectant mothers have sexually transmitted diseases before pregnancy, they should consider pregnancy after radical treatment, and if they do not carry out treatment early, it may cause serious consequences such as miscarriage, premature birth or premature rupture of membranes. The method of this examination is also relatively simple, that is, to check the vaginal secretions in detail, and women should keep their bodies and minds relaxed when they are examined.
2. Torch check
Tests include tests for rubella, cytomegalovirus, sporales simplex virus, and Toxoplasma gondii. Infection with these viruses may cause fetal growth limitations, or susceptibility to miscarriage and fetal malformations. The test only needs to be done by drawing blood from an vein, and the woman needs to be examined in the first trimester of pregnancy.
3. Urinalysis routine examination
A routine urine test can make an early judgment about the kidney condition of the mother. Pregnancy will increase the burden on the kidneys of expectant mothers, during pregnancy, the body's metabolism increases significantly, and the kidney load of expectant mothers is further aggravated, requiring urine routine examination. The test needs to be done in the first trimester of pregnancy and is done primarily by urine testing.
4. Blood routine examination
A blood routine can check as early as possible whether the expectant mother is anemic or has other hematologic disorders.
5. Liver function test (including two pairs and a half)
Pre-pregnancy liver function tests can timely understand the indicators of liver metabolic function and the basic situation of the liver of expectant mothers. If the mother carries the hepatitis B virus, it is possible to spread it vertically to the child. After the liver function test, expectant mothers can effectively prevent these conditions. On the day of liver function tests, expectant mothers should not carry out strenuous activities, ensure adequate sleep time, and have an empty stomach examination to prevent the impact on liver function indicators.
6. Oral examination
During pregnancy, expectant mothers have to consider the impact on the fetus when treating with drugs if their teeth are sore, which can be more troublesome to treat. This will have a certain negative impact on the pregnant mother and the fetus. If there are no health problems with the teeth before pregnancy, expectant mothers only need to clean their teeth every day; if the damage to the teeth before pregnancy is more serious, they need to undergo tooth extraction treatment. Women are recommended to undergo oral examinations in the first six months of pregnancy, especially women with periodontitis, caries and gingivitis and other related oral diseases before pregnancy, and should pay more attention to oral examinations before pregnancy.
7. Gynecological endocrine examination
The main examination content of gynecological endocrine examination is six examination items such as follicle stimulating hormone, estradiol and luteinizing hormone to determine hormone levels. Through intravenous blood testing, expectant mothers can generally get the test results 1 to 3 days after the examination. Expectant mothers who had menstrual irregularities and infertility prior to pregnancy should pay attention to this test.
8. Chromosomal abnormality examination
Chromosomal abnormalities are usually recommended in the presence of a bad maternal history. For example, couples with a history of infertility, unexplained stillbirth, recurrent miscarriage, and delivery of a child with congenital malformations.
9. Genetic examination
If a couple with a history of pregnancy is due to a child with a single gene disease, they need to come to the genetic counseling clinic for consultation. Assess the risk of reproduction. For example, couples in the south can have a genetic carrier test for thalassemia. Deaf couples or children who have had deafness need to be tested for the deafness gene. Or routine single-gene carrier screening, that is, to check whether couples have a "genetic collision". That is, whether both husband and wife have the same gene pathogenic gene mutation carrying, further eugenic consultation, and prevention of birth defects.
Do I need folic acid supplementation during pregnancy? How to supplement Dr. Tian?
Neural tube defects, also known as neural tube malformations, are a class of defects caused by incomplete neural tube closures early in embryonic development, including anencephaly, spina bifida, and cerebral bulge. Folic acid prevents neural tube defects.
1. Women without high-risk factors
If the planned pregnancy begins with 0.4 or 0.8 mg folic acid supplementation from at least 3 months before pregnancy until the end of 3 months of pregnancy.
2. Women with a history of neural tube defects
If the planned pregnancy begins with 4 mg or 5 mg of folic acid supplementation from at least 3 months before pregnancy to at least 3 months of pregnancy, reduce the dose as appropriate.
3. Women with hyperhomocysteinemia
Consider conception after taking 5 mg of folic acid daily until the blood homocysteine levels are normal. And 5Mg folic acid per day until at least 3 months of pregnancy.
4. Women with medium and high risk of folate metabolism genes
If planning a pregnancy begins with folic acid supplementation of 0.8 mg from at least 3 months before pregnancy.
Dr. Tian, what is the optimal age for childbirth and the best interval between births and pregnancies?
1. The best age for childbearing
As the mother ages, the risk of infertility, fetal aneuploidy, spontaneous abortion, gestational diabetes, preeclampsia, and stillbirth increases. Women should recognize these risks and the consequences of delaying conception until their 30s or 40s and consider them in their reproductive health plans. It is generally believed that the age of elderly women ≥ 35 years.
With the development of social economy, the reproductive age of men is constantly postponed. Although the age limit for advanced male age is still inconclusive, the risk of childbearing in elderly men is becoming more and more important. As men age, sexual function decreases, sperm quality decreases, and the prevalence of offspring increases. Studies have shown that men over the age of 35 or 40 are at significantly increased risk of decreased sexual function, decreased sperm quality, and increased prevalence of offspring.
2. Optimal delivery - pregnancy interval
The length of time between a particular pregnancy and the previous live birth. The optimal interval between births and pregnancies for most women is approximately 18-24 months, and the length of the interval needs to be adjusted if the mother is older and has experienced pregnancy loss. The American College of Obstetricians and Gynecologists recommends telling women to avoid pregnancy spacing
For older women, a gestational interval of 12 months may be preferable to 18 months, as it recognizes that the risk of fertility and infertility increases with age, while avoiding a shorter gestational interval (usually defined as).
Dr. Tian, how to adjust to the best state of pregnancy?
The following are proposed by a clinical working group of the National Preconception Health and Wellness Initiative that quality preconception care should achieve the following 9 goals at the time of the first antenatal visit:
1. Do not use tobacco.
2. There is no uncontrolled depression.
3. There is no sexually transmitted infection.
4. Avoid contact with teratogenic substances.
5. Weight health (BMI> 18kg/m2 and
6. Start using folic acid at least 3 months before pregnancy.
6. Blood glucose control is optimal.
7. Pregnancy as planned.
8. Conduct the first prenatal examination before 12 weeks of pregnancy.
Thank you very much Dr. Tian for your popular science today!
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