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Pre-Conception Advice
Any patient
presenting to a clinician needs to have
appropriate advice based upon their
individual medical, family, and social
history.
Medical
History
- Any
pre-existing medical conditions
which require specialist advice or
treatment?
e.g. diabetes, epilepsy, HIV, Hep B
or Hep C, psychiatric disorders,
hypertension. These patients will
usually benefit from early
specialist advice prior to
conception.
- Any
relevant past obstetric history?
e.g. still births, >3 miscarriages,
infertility. Consider referral to
gynaecology.
- Has the
patient been trying to conceive for
over 12 months already? Consider
infertility investigations and
referral.
- Is the
woman rubella immune? If not,
arrange testing and immunisation.
Also check that cervical smears are
up to date.
Family
History
If there is
any strong FH of genetic disease,
consider referral to Clinical Genetics
for advice about risk and possible
screening.
Social
History
Advise all
women trying to conceive to stop
smoking, and keep alcohol to a minimum.
Encourage a
varied & balanced diet. Avoid known
higher risk foods such as unpasteurised
dairy products, liver and undercooked
eggs. Take folic acid suppliments prior
to conceiving and until 12 weeks
gestation. Usual dose 400mcg daily, but
5mg daily where a past history of neural
tube defects, diabetes, or epilepsy.
Women should
avoid contact with contaminated cat
litter to reduce risk of toxoplasmosis.
Women should
not take any OTC medication (including
vitamins or mineral supplements) without
checking with a pharmacist. For
prescribed medicines, including herbal &
homeopathic remedies, she should seek
advice from the prescriber. Any illicit
drugs should be avoided (CDPS referral
may be needed).
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