“Every woman who menstruates, has sexual intercourse and does not use an effective contraceptive method is a candidate for or wants to become pregnant.”
This discourse is a fact of life that we face every day in daily life, rather than a prejudice or theoretical statement. The purpose of expressing this discourse given above; In the second half of the menstrual cycle, following ovulation, things get complicated when a pregnancy is detected by the examination performed after a situation that is not taken care of and the expected menstrual bleeding does not occur. For example, if there was a drug use or an x-ray etc., or if there was a possibility of a problem during the first uterine implantation phase of pregnancy, we are faced with the case.
“The best and least uneventful pregnancy is a planned pregnancy”
This second discourse should be an important basis of preparation for pregnancy. The need for every healthy person to take care of their own health comes up again here. Being pregnant in healthy conditions takes its place as the prerequisite for the best preparation. Being vaccinated against rubella, starting folic acid precautionary treatment, distinguishing personal and familial risk factors (Hereditary), recognizing the interactions of existing health problems with pregnancy and existing health problems of pregnancy, getting knowledge and awareness of the path to be followed during pregnancy are the most basic steps of pregnancy preparation.
Being aware of the high-risk situations that may arise before or during the course of a high-risk pregnancy due to the current situation is one of the important requirements of preparing for pregnancy.
Some example cases
It is beneficial for diabetics using pills to switch to insulin before pregnancy and keep their sugar levels in the range of 80-120. On the other hand, diabetic patients using insulin should switch to the insulin scheme, which is crystallized at meals and long-acting at night, instead of long-acting and single or two-dose insulin. In addition, it is essential to repeat organ examinations such as kidney-heart-eye. The incidence of congenital anomalies, miscarriages, large babies and problems at birth increases significantly in pregnancies with poor sugar control. With the preparation mentioned above, pregnancies can proceed without any problems, as in pregnant women who do not have diabetes.
Some drugs used by patients with blood pressure are contraindicated during pregnancy. In such cases, switching to drugs that can be used during pregnancy, controlling blood pressure, and bringing organ problems due to blood pressure disease to the optimal level will improve the health quality of both the baby and the pregnant woman.
Epilepsy patients should not stop their medication, but the type and dose of their medication may need to be changed. They should discuss this situation with their doctor and ask them for detailed information. Fetal echocardiography (examination of the baby’s heart) at 18-22 weeks of pregnancy is important in these patients.
The possibility of congenital anomalies is increased in those who take pills from blood thinners (especially in early pregnancy). Therefore, if treatment is absolutely necessary, they should switch to heparin-needle therapy.
In thyroid patients, especially in early pregnancy, complaints such as palpitation will increase or exacerbate due to overwork of the thyroid gland due to pregnancy. Those who use propylene-thiouracil to balance this, should discuss this situation with their doctor in detail and request information. It can be used during pregnancy, but it is necessary to use it under control and the baby should be followed up in the womb specific to this situation. The situation is different in those with less thyroid gland. Those with low thyroid gland are taking the missing hormone as a medicine against this condition and can continue to take it. The thyroid gland extract pills used do not pass and affect the baby. Hashimoto’s Disease has a different feature from the cases where the thyroid gland works less. Here, the sick person’s body secretes a harmful substance that prevents the functioning of its own thyroid gland and does not work. This substance can also prevent the thyroid from working in the mother’s womb by crossing the placenta during pregnancy. However, after 25-26 weeks of pregnancy, thyroid hormone is very important for the development of the baby and especially for the development of the brain. It can be investigated whether this situation occurs in the baby and if necessary, medication can be given in the womb.
It is beneficial for those with a family history of congenital heart disease to have fetal echocardiography performed during pregnancy. Because these families have an increased risk of congenital heart anomaly in the baby. If the pregnant woman has heart disease and uses medication, she should plan for her medications. They should have their heart function checked and if an intervention-treatment is necessary, it is beneficial for their quality of life to get pregnant afterwards.
It would be fair to say that those who have had the rubella vaccine have done an important and smart job in terms of the possibility of rubella in pregnancy. It is important and wise for people who are not immune to rubella to get vaccinated before pregnancy. Because when passed during pregnancy, they are likely to cause serious damage to the baby in the mother’s womb.