Before deciding to have a child, it is important to understand both your family and personal medical history, as you may be carrying a serious hereditary disease. For these conditions, once conception occurs, prevention is no longer possible.
Which women need care before conception?
All women of reproductive age, especially those with diabetes, phenylketonuria, certain infectious diseases, or genetic disorders, should seek care. Miscarriage can occur in about 25% of pregnancies for women with these conditions.
Why is understanding fetal development important?
Because it helps you avoid being in a situation where it is too late. When you notice a missed period, fertilization of the egg has usually already occurred (typically 17 days earlier), and a living embryo is rapidly developing within you. The cells of this embryo are differentiating to form the heart and many other organs. In fact, most organ formation occurs within the first three months after fertilization. The fetal heart begins to beat after the fourth week. By the eighth week, the eyes, ears, nose, mouth, fingers, and thumbs of the fetus can be identified. By around the twelfth week, most major organs have formed. It is during this early stage of organ development that the fetus is particularly vulnerable to drugs, viruses, chemicals, and other factors that can lead to disabilities.
What is the significance of understanding your family and personal medical history?
You or your partner may carry a serious genetic disorder. In such cases, you will receive counseling to reduce the risk of passing the disease to your child. Once conception occurs, prevention is no longer possible. Healthcare providers also need to know your obstetric history (for those who have been pregnant before), such as the number of miscarriages, preterm births, difficulties with conception, or any gynecological issues to take preventive measures for future pregnancies. Based on your examination data and medical and obstetric history, doctors can help improve your chances of having a healthy child.
Is genetic counseling and detecting genetic abnormalities really necessary?
Improving population health is a priority in developed countries, making this work highly relevant… This approach is aimed at enhancing the quality of future generations, both physically and mentally. If a doctor suspects that you have a genetic disorder, various genetic screenings may be conducted for you; and if you are pregnant, tests will also be performed on the fetus (through amniotic fluid and chorionic villus sampling). Currently, there are over 1,500 genetic diseases. Many serious genetic disorders are linked to ethnicity.
In addition to genetic diseases, what other conditions should be monitored?
Type 1 diabetes (insulin-dependent) should be diagnosed before pregnancy. If blood sugar levels are well-controlled during pregnancy, the risk of having a child with congenital abnormalities can be reduced, and complications for the mother can be avoided.
There are several diseases that can pose risks to pregnancy for the mother. For example, rubella and hepatitis B can affect the fetus, so it is essential to establish immunity (vaccination) against these diseases before conception. If contracted in the early stages of pregnancy, rubella can cause damage to the eyes, ears, and heart of the fetus. Hepatitis B is often sexually transmitted and can be passed from mother to fetus, with newborns potentially becoming carriers and suffering severe liver function complications.
Doctors may order various tests to mitigate risks to the fetus if they identify potential infection risks. For instance, if you have a cat and frequently handle raw meat, testing for toxoplasmosis may be necessary… Some sexually transmitted infections (gonorrhea, syphilis, chlamydia, HIV/AIDS…) should be treated before conception.
How can diet and medication prevent adverse effects on the fetus?
As soon as you plan to conceive, your doctor should inform you about the harmful effects of certain common medications. For example, the acne medication Accutane should be avoided as it may increase the risk of fetal malformations; or consuming excessive amounts of vitamins A, B6, C, D, E, K, iron, zinc, selenium… can be harmful during pregnancy.
Daily supplementation with folic acid is the best way to protect the nervous system of your future child, reducing the risk of spinal defects, especially when started early in pregnancy and for women with a history of giving birth to children with neural tube defects. Doctors will also advise on the detrimental effects of alcohol, tobacco, and other addictive substances on pregnancy—these are also the most common and easily avoidable harmful factors. These substances can lead to premature birth, low birth weight, cognitive delays, facial deformities, and many other defects.
In summary, preconception care is not only about advice but also involves proactive prevention. For some cases, visiting a prenatal care unit after conception may often be too late.
Dr. Dao Xuan Dung, Health & Life
