Choose the content to read
- Why a preconception checkup?
- What is included in a preconception checkup?
- Should males come to a preconception checkup?
- When is the best time for a preconception checkup?
- What is the preparation before pregnancy?
- Preconception Checkup MedPark Hospital
Preconception checkup
Preconception checkup is a health examination for both the prospective mother and father to assess their readiness to conceive. This pre-pregnancy screening aids in planning, pregnancy health preparation, and the conception of a healthy baby. Preconception checkup screens for genetic disease risks such as thalassemia and assesses infertility in women, including anovulation, or women over 35 years, and infertility in men, such as weak sperm. Additionally, a preconception checkup assesses pregnancy risks associated with lifestyle behaviors, aids in lifestyle change, and promotes a child's smooth and safe conception.
Why a preconception checkup?
Preconception checkup screens for genetic and behavioral risk factors, leading to optimum pregnancy planning; encourages the cessation of risky behaviors affecting the fetus; prepares and nourishes maternal health; and assists women with certain underlying diseases, including diabetes and high blood pressure, in having a safe pregnancy.
List of preconception checkup programs?
- Physical examination
- Complete blood count (CBC)
- Blood group (ABO/Rh)
- Thalassemia carrier testing (Hb typing)
- Hepatitis B testing (HBsAg)
- Hepatitis B immunity testing (HBsAb)
- HIV testing
- Syphilis testing (VDRL)
- Hepatitis C testing (anti-HCV)
- Rubella IgG testing
- Pelvic exam, cervical cancer test (Thin Prep test)
- Uterus and ovaries ultrasound (transvaginal ultrasound)
What is included in a preconception checkup?
General Health Checkup
- Medical history: the doctor will take a detailed medical history, including:
- Underlying diseases such as diabetes, phenylketonuria, and neural tube defects
- Drug allergies, medication, dietary supplements
- Previous medical treatment, accidents, and chronic disease management
- Menstruation history, regularities of menstruation, amenorrhea
- Pregnancy history, complications of pregnancy during and after delivery, premature birth, twin pregnancy, miscarriage, and history of surgery, e.g., chocolate cysts, uterine tumors, endometriosis, history of traumas.
- Family history of genetic disorders, such as diabetes, thalassemia, and Down syndrome
- Weighing: determining pre-pregnancy weight, whether underweight, normal weight, overweight, or obese, to reduce gestational complications such as low-birth-weight babies or gestational diabetes.
- Measure height to rule out labor dystocia (difficult or obstructed labor), especially in women shorter than 140 cm who often have a narrow pelvis. The doctor will advise on a safe delivery method to help reduce the risk of childbirth.
- Taking blood pressure to assess the risk of high blood pressure (hypertension) during pregnancy. High blood pressure during pregnancy can result in seizures, intracerebral hemorrhage, and even death.
- Physical examination to assess health and physical readiness, including checking the cardiovascular system, lungs, abdomen, signs of anemia, swelling, and other abnormalities.
- Blood tests, blood group tests (ABO blood group), and complete blood counts (CBC; Hct/Hb MCV) to measure hemoglobin levels, which help carry oxygen to the fetus, as well as checks for low MCV (blood cell size) correlated with thalassemia carrier.
- Transvaginal ultrasound: an ultrasound of the uterus and ovaries to look for abnormalities in the female reproductive organs, including polyps, lumps, tumors, and chocolate cysts, and uterine and ovarian abnormalities, which can cause infertility.
- Thin Prep Test: A pelvic exam and a cervical cancer screening to look for changes in cervical cells, cancerous lesions, early-stage cervical cancer, or advanced cervical cancer that causes abdominal pain, chronic vaginal discharge, or bloody vaginal discharge.
Vaccination Status Check
The doctor will discuss pregnancy vaccinations for those planning to conceive to prevent congenital anomalies, miscarriages, and other complications that could harm the fetus. Preconception vaccination should include:
- Mumps, Measles, and Rubella (MMR) vaccine
- Diphtheria, Tetanus, and Pertussis (Tdap) vaccine
- Hepatitis B vaccine
- Chickenpox vaccine
- Influenza vaccine
*COVID-19 vaccine (depending on the individual's vaccination history)
STD Testing
To prepare for pregnancy, the doctor will conduct a sexually transmitted disease screening (STD testing) for a woman. To ensure a safe pregnancy, men should also be screened to prevent complications of sexually transmitted diseases during pregnancy, including premature birth, low birth weight babies, eye and lung infections, fetal death or stillbirth, postpartum hemorrhage, and miscarriage. Sexually transmitted diseases screened for before pregnancy include testing for:
- Syphilis testing (VDRL)
- Hepatitis B testing (HBsAg)
- Hepatitis C testing (HCV)
- HIV testing
Genetic Testing
During preconception checkups, the doctor will take blood samples for genetic testing to detect hereditary mutated genes or carriers, aiming to prevent transmitting diseases to children. Particularly, if there is a history of genetic disorders running in the family, the doctor may request additional genetic testing depending on the couple's risk. These might include expanded carrier screening to identify specific genetic carriers and consider options like medical technologies for having children, such as PGT-A, preimplantation genetic testing for aneuploidies, followed by IVF or ICSI. Genetic disorders that should be screened for before conceiving include:
- Anemia
- Thalassemia
- Sickle cell disease
- Cystic fibrosis
- Tay-Sachs disease
- Fragile X syndrome
- Muscular dystrophy (MD)
Dental Checkup
Dental checkup by the dentist before conceiving is an important part of the preconception checkup because when pregnant, hormones in the body change, predisposing to gingivitis, irritated gums, red and swollen gums, bleeding gums, and possible infection that affects the fetus and may result in premature birth and low birth weight babies. During a preconception checkup, the dentist will examine the gums and teeth and treat any of the following symptoms:
- Toothache, tooth decay, or a large dental caries
- Gum pain, swollen gums, and gingivitis
- Loose teeth
- Periodontitis, bleeding gums
- Tooth abscess, pus coming out of the gums
- Wisdom teeth, infected wisdom teeth
- Necessary tooth extraction, despite being asymptomatic
Mental Health Checkup
The doctor will conduct a mental health screening to assess the mental readiness before, during, and after pregnancy, which is crucial to achieving a successful pregnancy outcome, and whether the pregnant mother is ready to raise her child after birth. During the preconception checkup, the doctor will discuss and ask general questions to ensure that none of the following conditions are present.
- Stress and anxiety
- Sadness
- Depression
Should males come to a preconception checkup?
Doctors recommend that men should also undergo a preconception checkup to screen for health risks and receive advice on changing lifestyle behaviors that may affect the pregnant mother and the fetus, such as smoking in male partners, which can reduce sperm counts and lead to infertility, or certain sexually transmitted diseases, such as syphilis, which can cause hearing and vision impairments in babies as well as premature birth.
When is the best time for a preconception checkup?
Doctors recommend that those planning to have children have a preconception checkup at least 3 months before conceiving to prepare for a healthy physical, such as taking one tablet of folic acid (0.4-0.8 milligrams) every day for 3 months to help reduce the risk of congenital anomalies, and changing behaviors such as quitting smoking, stopping drinking alcohol, or avoiding contact with toxins or chemicals. Furthermore, those with underlying diseases such as diabetes, asthma, seizures, obesity, high blood pressure, depression, oral and dental issues, or infertility should have a preconception checkup more than 3 months in advance to plan a safe pregnancy and reduce the risk of complications during pregnancy.
What is the preparation before pregnancy?
- Eat nutritious foods from all 5 food groups and boost protein intake with omega-3-rich fish, meat, milk, eggs, and five-colored vegetables and fruits.
- Take folic acid and iodine supplements to help prevent neural tube defects or hypothyroidism
- Get a preconception checkup and all necessary vaccinations before the planned pregnancy.
- Exercise regularly to maintain a normal body mass index (BMI).
- Get enough sleep and relaxation, and avoid stress and anxiety.
- Limit your intake of caffeine, tea, coffee, and soft drinks, and refrain from smoking and consuming alcohol.
- Those with health problems, chronic diseases, or infertility should consult a doctor.
Preconception Checkup MedPark Hospital
Obstetrics and Gynecology Clinic and Fertility and Genetics Center, MedPark Hospital, Bangkok, Thailand, are led by teams of expert obstetricians and gynecologists who specialize in reproductive medicine, infertility, and preconception planning, along with a highly experienced multidisciplinary professional healthcare team, are ready to provide consultation on preconception care and comprehensive preconception checkup, assisting prospective mothers and fathers in pre-pregnancy preparation, childbirth, and postpartum care, supported by ISO 15189 and ISO 15190 accredited clinical laboratories and state-of-the-art genomics technology to accurately and precisely identify rare disease genes or mutated gene carriers, enabling conception of a healthy baby, while also providing postpartum health follow-up for both mothers and babies to help mothers recover quickly and babies develop appropriately for their stages, bonding love for all family members.
