Planning to get pregnant Hepatitis B is triple positive and my liver function is normal on regular checkups, can I get pregnant? When is the right time to get pregnant? A: Hepatitis B infected women with normal liver function can get pregnant. It is recommended that you review your liver function in the near future, and if the result is normal, you can plan to get pregnant without contraception in the near future. It is recommended that you start taking multivitamins containing folic acid 3 months prior to the date of pregnancy in order to reduce the rate of birth defects. Q:25 years old, Hepatitis B triple positive, checked liver function abnormality half a year ago, but did not take medication, can I get pregnant now? A:We suggest you to check your liver function first, if the result is normal, you can get pregnant. If the result is abnormal, you need to go to the Department of Infectious Diseases or Department of Hepatology for treatment until your liver function returns to normal and your liver function is normal again after 6 months or more after stopping medication before you can get pregnant. Thyroid Disease Q:I am 23 years old with hypothyroidism and planning to get pregnant. A:Before pregnancy, you should undergo a comprehensive and detailed physical examination, and adjust the dosage of Euthyrox according to the TSH situation, so as to maintain the level of thyroid hormone in the normal range, and keep the TSH below 2.5 mIU/L before pregnancy, and preferably keep the TSH <1.5 mIU/L. This is because a lower level of TSH prior to pregnancy can reduce the risk of hypothyroidism in the early stage of pregnancy. Q:23 years old, planning to get pregnant, has hyperthyroidism. She is now taking the antithyroid drug methimazole (MMI) for hyperthyroidism, can she get pregnant now? Do I need to continue the medication? A: Before you become pregnant, you need to see an endocrinologist to adjust your medication. Because methimazole (MMI) can cause fetal developmental abnormalities, it is recommended to switch to propylthiouracil (PTU) before pregnancy and in early pregnancy to control thyroid function in the normal range before getting pregnant, and to maintain FT4 close to or slightly above the upper limit of the normal reference range. You will need to stay on medication throughout your pregnancy and breastfeeding, and due to the risk of liver function damage with PTU, it is recommended to switch back to treatment with MMI in mid to late pregnancy and breastfeeding. Q:26 years old, 3 months after 131I treatment for hyperthyroidism, I am now rechecking my thyroid function and it is already within the normal range, can I get pregnant now? Is it possible to get pregnant now? Will it have a big impact on the baby? A:It is not recommended to get pregnant. Because 131I treatment is a radioactive substance with a long half-life, it can cause teratogenic effects on the fetus, and it is generally recommended to wait at least 6 months after 131I treatment before preparing for pregnancy.After 131I treatment, women are at a slightly higher risk of miscarriage, which may be related to secondary hypothyroidism, and therefore need to maintain their thyroid function within the normal range before getting pregnant, and need oral supplementation with thyroxine if necessary. Thyroxine. No other increased risk of adverse pregnancy outcomes has been observed in patients who have been treated with radioactive iodine for more than 6 months. Systemic lupus erythematosus Q:28 years old, planning to get pregnant. I have had SLE for 5+ years and am now on regular medication and the disease is well controlled, can I get pregnant? A:Generally speaking, if you do not have significant organ damage, your condition has been stable for more than 1 year, and cytotoxic immunosuppressants (e.g. cyclophosphamide, methotrexate, etc.) have been discontinued for half a year, and you are now taking a small dose of hormone for maintenance (≤10mg/d) to control your condition, then you can consider getting pregnant. However, you still need to have regular follow-ups in the rheumatology department to monitor your condition. Q:30 years old, diagnosed with systemic lupus erythematosus (SLE) for 3 years, stopped using cellular immunosuppressants for 1 year, and is now taking oral low-dose maintenance, and the disease is under control. Can I get pregnant? A:Whether or not you can get pregnant depends on the opinion of your internist (immunologist) and your specific situation. From what you have described, you can get pregnant, but there are reports of exacerbation and remission of SLE in pregnancy, so you need to be monitored and managed by both your internist and obstetrician. If your internist has assessed that your current condition is stable and you are ready to get pregnant, then you should get pregnant because SLE is an autoimmune disease and it is not easy to recover completely, so you can get pregnant after your condition has stabilized for a period of time. It is recommended that you start taking a multivitamin containing folic acid 3 months prior to pregnancy and abstain from smoking and alcohol. The disease may worsen during pregnancy and there is an increased risk of pre-eclampsia, which requires regular monitoring of blood pressure and review of urine protein, etc. Enhanced prenatal checkups are done under the joint monitoring of an obstetrician and an immunologist. Q:I am 23 years old and planning to get pregnant. Mycoplasma and Chlamydia infections were found in my vaginal secretion test before pregnancy, what should I do? Can I get pregnant now? A:Mycoplasma and Chlamydia infections may increase the risk of infertility, miscarriage, preterm delivery, fetal malformation, etc. It is recommended that you undergo regular treatment at a gynecological clinic for 3 months before reviewing the test, and if the infections are cured, you can start to prepare for pregnancy. However, it should be noted that there is a possibility of false-positive test results, so it is recommended that you go to a regular hospital for review and find out if you are in the acute phase of the infection. Environment and Diet Q:30 years old, cardiology interventionalist, planning to get pregnant, do I need to stop the intervention? How long do I need to stop? A:There is no need to stop working. Studies have shown that the radiation inhalation in cardiology interventional department is not high, and the highest absorbed dose to each organ is nearly 200mGy to the red bone marrow, while the absorbed dose to other organs and tissues is not more than 100mGy, and the absorbed dose to the gonads and other tissues is generally not more than 5mGy, and these doses do not have a teratogenic effect. The dose of radiation has to exceed 100mGy to cause fetal malformation. X-ray exposure can be effectively reduced by more than 92% by wearing lead protective clothing and lead neck caps. It is sufficient for interventional cardiologists to wear protective clothing during operation. Q:28 years old, airport security worker, planning to get pregnant, do I need to transfer? A:No transfer is required. The radiation caused by security checkers is very low, even much lower than the natural radiation received in daily life. Therefore, it can be ignored and there is no need to worry about teratogenicity or miscarriage. Q:I am 29 years old and planning to get pregnant. My husband is a heavy smoker and drinker and we are planning to have a baby, is it necessary to quit smoking and drinking? A:You should quit smoking and drinking when planning to get pregnant. Previous studies have found that smoking and drinking reduce the conception rate, increase the incidence of malformations, and cause miscarriage, slow growth of the fetus, and premature labor, so we recommend that your husband quit smoking and drinking. Of course, if you really can't quit, you should also cut down on smoking and alcohol. Q:I am 27 years old and planning to get pregnant. I smoke and drink, what are the dangers of smoking and drinking? How long do I need to stop smoking and drinking before I can get pregnant? A:Previous studies have found that smoking and drinking reduce the conception rate. In addition, even if you get pregnant, the risk of miscarriage is high in the early stages, and the risk of intrauterine growth restriction and preterm labor is also high in the middle and late stages, so you should quit smoking and drinking before you get pregnant. Q:I am 28 years old, planning to get pregnant, I have cats at home, I am planning to have a baby, what tests do I need to do and can I continue to have cats? (Refer to SOGC 2013 guidelines) A:Toxoplasma gondii infects people through three main ways, eating raw meat, exposure to cat feces with infectious eggs, and vertical transmission. Transmission of Toxoplasma gondii from cats to humans only occurs when cats are infected, feces with Toxoplasma gondii eggs are excluded, and humans are exposed to the feces. According to a European survey on 24,106 cats, it was found that there was only a 0.11% infection rate. Domesticated cats that don't eat raw meat or hunt for food are very unlikely to be infected with toxoplasmosis and cats can be vaccinated against toxoplasmosis. Overall as long as you can ensure that your domesticated cat is not infected with toxoplasmosis, you can continue to keep your cat. To prevent your cat from contracting toxoplasmosis, you can do the following: Do not feed raw meat or untempered milk to your cat. It is best to keep your cat completely indoors and avoid contact with infected soil, animals, and raw meat. Scoop cat litter daily and wash the litter box often with boiling water. Pregnant women avoid cleaning cat litter. Avoid feral cats and do not get a new cat while pregnant. Avoid toxoplasmosis infection during pregnancy: Pregnant women should not consume raw meat, unpasteurized dairy products, and unwashed fruits and vegetables. Do not drink water that may have toxoplasmosis eggs unless it is boiled. After handling raw meat, wash your hands well with soap and clean countertops. Freeze raw meat at -20° to -4° to kill eggs. Gloves are required when touching plants and trees as well as soil. Wash your hands before eating. Q:I am 29 years old, 1 month after an abortion. I am planning to have a baby now, how long do I need to wait before I can get pregnant? The internet says I need to wait at least six months, do I really need to wait that long? A:Generally speaking, you can get pregnant as soon as your period resumes. Recent studies have shown that there is no significant difference in survival rates and adverse pregnancy outcomes (including miscarriage) between pregnancies three months after miscarriage and pregnancies three to six months after miscarriage, and the average duration of pregnancy in the three months after miscarriage group was less than nine weeks, which means that you can get pregnant two to three months after miscarriage and there is no impact on the health of your child. So you can get pregnant two or three months after the miscarriage when your period resumes. Of course, it is better to wait for six months to allow your body to fully recover and be mentally prepared. Q:My husband and I live and work in a big city, but the air quality is poor. I am planning to get pregnant now, will the poor air affect the development of my baby? A:Studies have found that exposure to residential and traffic-related air pollutants during pregnancy is detrimental to the growth and development of children's lungs and may lead to long-term impairment of lung function during the preschool years. However, human beings have a strong adaptive capacity, and most of them are generally not very ill. If you are a person who has a poor reproductive history or is particularly sensitive, it is recommended that you wear a mask when encountering poor air quality, and that indoor air purifiers can be used. Q:I am 29 years old and planning to get pregnant, I have a dog and now I am planning to have a baby, can I continue to have a dog and do I need to do any tests? A:Dogs are only intermediate hosts of Toxoplasma gondii, i.e., hosts required for the larval stage, and do not excrete Toxoplasma gondii eggs. Routine contact does not usually lead to Toxoplasma gondii infection, unless you consume raw dog meat containing infectious Toxoplasma gondii eggs. So you can basically be assured of owning a dog. If you are psychologically burdened, you can undergo a TORCH test before pregnancy to rule out related infections. Weight Management Q:2+ months after natural delivery, 26 years old, height 165cm, weight before pregnancy 55kg. now weight 71kg. i would like to have my second child, is there anything i need to pay attention to? A:You had a normal weight before pregnancy, but now you are overweight. It is recommended to control your weight to between 50.4-65kg before your next pregnancy. At this stage, if there is no contraindication to breastfeeding, you can breastfeed and adjust your diet reasonably and take multivitamins or calcium supplements to help your weight return to normal. If you are planning to have a second child, start taking folic acid or multivitamins containing folic acid 3 months before your next planned pregnancy, and quit smoking and drinking. Q:1 year after natural delivery, 29 years old, 160cm tall, now weighing 71kg. i want to have my second child and would like to ask if there is anything i need to pay attention to? A:You are overweight, it is recommended to reduce your weight by about 5-10kg before pregnancy, do more exercise, adjust your diet reasonably, reduce calories, take 1 tablet of multivitamin and calcium supplements every day, and reduce your weight gradually, do not reduce your weight drastically, so as not to hurt your body. If you can't lose weight, you can still get pregnant, but you shouldn't gain too much weight during pregnancy. Anemia Q:I am planning to have my second child. I suffered from iron deficiency anemia during my last pregnancy, what should I pay attention to in order to prevent the occurrence of anemia during this pregnancy? A:Blood tests and ferritin should be checked during the first checkup and repeated every 8-12 weeks. Hematocrit below 110g/L needs to be supplemented. If Hb is normal but serum ferritin is less than 30mg/L, oral iron supplementation is still needed. Other Diseases Q:30 years old, gallstones with chronic cholecystitis for 2+ years, planning to get pregnant. What should I pay attention to? A:Physiologic changes and dietary changes during pregnancy may increase your risk of acute attack of cholecystitis or even biliary pancreatitis. You may first visit the Hepatobiliary Surgery Department to evaluate whether surgery is needed to treat gallstones. Start taking multivitamins containing folic acid 3 months before you plan to get pregnant and stop smoking and drinking. Q:I am 25 years old, and during my pre-pregnancy checkup, I found that my rubella virus IgM value is 10 U/mL above the upper limit of normal value, what should I do now and do I need treatment? A:The IgM antibody test reflects whether you have had rubella infection in recent times, and according to your case, it indicates that you may have rubella infection. You are advised not to get pregnant for the time being and go to the Infection Department first to assess your condition and treat it if necessary. Generally speaking, rubella is a self-limiting disease and usually requires no special treatment. Ribavirin can be used as an antiviral if necessary, but ribavirin belongs to class X drugs and is contraindicated in pregnant women. If you need to take it, you should stop taking it for 6 months before getting pregnant. Q:26 years old, not pregnant for one and a half years after marriage, usual dysmenorrhea, gynecological physical examination found tender nodules in the posterior fossa of the traps, the doctor said to consider pelvic endometriosis, is it this that affects my ability to get pregnant? Can I still get pregnant? What can I do now? A:Endometriosis can indeed reduce fertility and is a common cause of infertility, but it is not the only cause of infertility. It is recommended that you do multiple examinations and preparations at the same time, firstly, monitor whether there is ovulation or not, you can check the sex hormone set or ultrasound or ovulation test paper to monitor; the husband should do semen examination at the same time; and tubal iodine oil angiography to check whether there is any organic cause of the fallopian tube. After ruling out all the causes, we can consider laparoscopic surgery to explore the tubes, which can find lesions as well as deal with pelvic adhesions, etc. If ectopic nodules are found during the surgery, we can take medication according to the doctor's instruction after the surgery and follow the gynecologist's advice for follow-up, and then get pregnant after stopping the medication; if we still do not get pregnant for a long period of time, we can consider assisted reproduction techniques to help us get pregnant. Q:30 years old, had a cesarean section 2 years ago, now I have pain in the scar area of the abdominal wall during menstruation, and I feel hard nodules, which have increased in size in the last year, what is the reason for this? What is the reason for this? I want to have a second child, when is the best time? A:There is a clear correlation between abdominal wall scar pain and menstrual period, and the hard nodules that are gradually growing in size suggest the possibility of endometriosis in the abdominal wall scar area. If symptoms are severe and persistent, scar removal may be considered. If you are pregnant, it is just the right time to treat it and alleviate its symptoms, and if the symptoms are reduced, you may consider expecting until pregnancy and removing the ectopic nodules from the abdominal wall scar along with the next surgery. Now that you are 2 years post cesarean section, pregnancy is possible at any time. Q:27 years old, ultrasound suggests possible adenomyosis, will it affect pregnancy? Does it need to be treated? What do I need to prepare for pregnancy? A:If adenomyosis is mild and not accompanied by other diseases, it usually has no effect on fertility. If it is not accompanied by severe dysmenorrhea, it can be left untreated, and pregnancy itself has a protective effect on the disease, so it is recommended to get pregnant as early as possible. If adenomyosis is large or severe, it often interferes with conception and is a cause of adverse pregnancy outcomes such as miscarriage and preterm labor, so getting pregnant early is paramount, and if pregnancy is not possible, treatment is needed. Before pregnancy, it is important to stop smoking and drinking, and to develop good living habits. It is recommended to take multivitamins containing folic acid in the first three months of pregnancy. Q:I am 24 years old and have asthma, now my condition is under control, can I get pregnant? What should I pay attention to? A:It is recommended that you go to a respiratory specialist to evaluate your condition and adjust your medication. If your condition is under control, you can get pregnant, but be aware that taking cortisone during the early 3 months of pregnancy may pose a risk of cleft lip and palate, which should be avoided as much as possible. Meanwhile, theophyllines should not be used during the first 3 months of pregnancy, but it has been proven to be safe to use a moderate dose in the middle and late stages of pregnancy. Q:27 years old, myasthenia gravis oculomotor type for 2+ years, now taking oral prednisone 20mg daily to maintain the condition. I want to have a baby, does the drug have any effect and what other tests do I need to do? A:Prednisone is considered safe in pregnancy and lactation, but may increase the risk of gestational diabetes mellitus, hypertension, and infections. However, discontinuing the medication hastily may cause exacerbation of myasthenia gravis, and you will need to continue the medication, as well as consult with the neurologist to adjust the dosage of the medication and maintain it at the lowest effective dose. Thyroid function and its autoantibodies can be checked before pregnancy to ensure normal thyroid function at the time of pregnancy.