Pre-Conception Advice

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).