Pregnancy is a systematic project and pre-conception and pregnancy care are important measures to reduce birth defects. Eugenics is the common desire of every couple and is the most important topic of concern for all mothers-to-be, yet not every couple has a clear understanding of how to do it before pregnancy, so it is necessary to have a detailed knowledge of proper preconception health care to be fully prepared for the birth of a healthy baby.
Recently, the United States, the United Kingdom, Canada and WHO have released the latest preconception health care guidelines and evidence-based medical evidence, referring to the above guidelines, following the “Preconception Health Care Service Work Specifications (Trial)” (2007) and “National Free Preconception Eugenics Health Screening Program Pilot Work Technical Service Specifications (Trial)” (2010) issued by the Ministry of Health and the Family Planning Commission, and the “Preconception Health Care Guidelines (Trial)” (2010), which are suitable for our national conditions. Preconception Health Care Guide” (the first edition) was officially released in November 2011 for the whole network.
The contents of this guide include: health education and guidance, routine health care contents, and auxiliary examination items (divided into mandatory items and preparation items), which are applicable to all pregnant women. This lecture interprets the Preconception Health Care Guide and explains the knowledge related to preconception health care (physiology, psychology, diet, medicine, environment and disease) and preconception checkups with examples, so that couples of childbearing age can understand the importance and significance of preconception health care before pregnancy, which has certain practical guidance value.
I. Health education and guidance
We follow the principle of combining universal guidance and individualized guidance to provide preconception health education and guidance to couples planning pregnancy, including the following
(1) Prepare and plan for pregnancy and avoid pregnancy at advanced age.
(2) Rational nutrition and control of body mass (weight) gain.
(3) How to supplement folic acid.
(4) Women with genetic, chronic and infectious diseases who are preparing for pregnancy should be evaluated and guided.
(5) Rational use of medication and avoidance of drugs that may affect normal fetal development.
(6) Avoid exposure to toxic and harmful substances in the living and occupational environment (such as radiation, high temperature, lead, mercury, benzene, arsenic, pesticides, etc.) and avoid close contact with pets.
(7) Change bad habits (such as smoking, alcoholism, drug abuse, etc.) and lifestyles; avoid high-intensity work, high-noise environments and domestic violence.
(8) Maintain mental health, relieve mental stress, and prevent the occurrence of psychological problems during pregnancy and after delivery.
(9) Choose exercise reasonably.
II. Routine health care
1. Assessment of pre-pregnancy high-risk factors: (1) Ask about the health status of the couple preparing for pregnancy. (2) Assess previous history of chronic diseases, family and genetic history. (3) Detailed history of adverse pregnancy and childbirth. (4) Lifestyle, diet and nutrition, occupational status and work environment, exercise (labor) situation, domestic violence, interpersonal relationships, etc.
2. Physical examination: (1) Including measurement of blood pressure, body mass, and calculation of body mass index (BMI). (2) Routine gynecological examination.
3. Auxiliary examinations
1. Compulsory examinations: including the following items.
(1) Blood routine;
(2) Urine routine;
(3) Blood type (ABO and Rh);
(4) Liver function;
(5) Kidney function;
(6) Fasting blood sugar;
(7) HBsAg;
(8) Syphilis spirochete;
(9) HIV screening;
(10) Cervical cytology (for those who have not been examined within 1 year).
2. Preparation items: including the following items.
(1) Toxoplasma gondii, rubella virus, cytomegalovirus and herpes simplex virus (TORCH) screening.
(2) Cervicovaginal discharge test (routine vaginal discharge, gonococcus, Chlamydia trachomatis);
(3) Thyroid function test;
(4) Thalassemia screening (two provinces, two lakes, Hainan, Sichuan, Chongqing, etc.);
(5) 75g oral glucose tolerance test (OGTT; for high-risk women);
(6) Blood lipid screening;
(7) Gynecological ultrasonography;
(8) Electrocardiogram