Conducting a Pre-conception Clinic

In the conduction of the pre-conception clinic, women are given standard questionnaires to extract information on personal, family history, social history, past medical and surgical history, history of previous pregnancies. The immunization history of the client is also determined. Relevant blood test and other investigations are also carried out. Women are thereafter counseled on their preparedness or otherwise for pregnancy and are thus able to make informed decisions and plan for pregnancy. Clinic attendance is flexible and tailored to the need of the client. Certain factors will however influence the nature of the Preconception clinic and will include the following:

-The environment

-Prevalence of certain health conditions

-Proximity to the next pregnancy

-Previous experience in previous pregnancies

-Type and use of contraception

-Previous medical conditions

-History of previous surgery

-Genetic makeup of the couple contemplating pregnancy

-Habits such as smoking and alcoholism and drugs of addiction

-Allergic reaction to drugs and or food

-Occupation and nature of Job

Health Issues for the Zygote in the first one week of Life

In the first one week of life, the greatest concern for the zygote is the risk of development of chromosome(al) and genetic abnormalities. This risk is influenced by factors inherent in the genetic makeup of the parents and factors that influence division and multiplication of genes and chromosomes.
Genetic disorder occurs when there is an abnormality with genes and chromosomes.
Genetic disease can occur when there is either a single defective gene or a group of defective genes. A chromosome(al) or genetic disorder can also occur when there is a fault in the number and shape of chromosomes.
A common chromosomal disorder is Down’s syndrome. This occurs when a zygote has 47 chromosomes instead of the usual 46 chromosomes. In this condition, the egg is usually defective because it carries the extra chromosome.
In Down’s syndrome the extra chromosome is sited at the 21st position. Out of every 1,000 babies, one will be born with Down’s syndrome. The risk of occurrence occurring randomly but it is known to be associated with parents with genetic disorders.
Other conditions exist where an extra chromosome is added at different positions in the chromosome pair, they are known as Edward’s and Patau’s Syndrome. They are however rarer than Down’s syndrome.
These chromosome disorders are associated with physical abnormalities and mental retardation. There is increased incidence in mothers of advanced age. The risk factor is about 1 in 350 at age 35 and 1 in 125 at age 45. The incidence in 1 in 75 at age 50years. This should not be a cause of unnecessary worry for mothers of advanced age as even at age 50, out of every 25 women, 24 of the women will still escape chromosomal abnormality. This is not also to encourage late child-bearing as it is obvious that the risk of chromosomal abnormality increases with advanced age.
Another genetic disease of concern in this part of the world is sickle-cell anaemia. This occurs in 1 in 350 Nigerians. There is inheritance of defective heamoglobin from the parents by the baby. This is the commonest genetic disease of black peopleworldwide. When both parents are carrier of the heamoglobin trait that is they have the genotype AS, the risk of having a child with the disease is 25% but 50% when one parent has the disease and the other is a carrier that is SS and AS genotype combination.
It is therefore wise for intending couples to carry out a genotype screen before planning a family. In a situation where a couple carry genetic traits of sickle cell anaemia that will predispose their child to having sickle cell anaemia or a carrier trait, they can be counseled to have pre-implantation genetic diagnosis. This will determine the genotype of the baby before implantation. The couple will however have to resort to assisted reproductive technology to enable them determine the genotype of the baby before implantation. Prior to the use of this technology, chronic villus biopsy which involves obtaining tissue from the placenta of the fetus before 14weeks to determine the genotype was the method used in the determination of Genotype of babies suspected to have sickle cell disease while in-utero (inside the womb). This method has been taken over by pre-implantation genetic diagnosis. Overall, this method is laced about by numerous religious and human rights issues and rightly so!
Other forms of genetic disorders that will be mentioned but not discussed in details on account of their relative rarity in our environment, include Cystic fibrosis, thalassaemia, Tay-Sachs disease and others related to gender such as Hemophilia (a bleeding disorder)
Poor arrangement of chromosomes that are inherited from parents can lead to a condition known as translocation of chromosomes. In translocation the parents are normal but the child becomes abnormal if he receives the chromosome pair that is poorly arranged.
When there is abnormality related to the sex chromosomes (i.e. X and Y), it can lead to defects in sexual development of the baby, infertility and other forms of abnormality. Some example includes a situation where a female baby has only one X chromosome instead of two. This is referred to as Turner’s syndrome.
Male babies may suffer from a condition where they have two or more X chromosomes instead of one, this is referred to as Klinefelter’s syndrome it is associated with male infertility in adulthood.
The aim of this discussion is not to instill fear into you but to raise your awareness on the wide range of abnormalities that can occur early in the development of the baby and the possible risk factors.
But it is important to be reassured that far more babies are born normal rather than abnormal. As a matter of fact, normality is the rule. For babies that have inherent chromosomal and genetic abnormalities, most of these babies will suffer miscarriage and will not progress beyond the first eight-ten weeks of life. Chromosomal and genetic abnormalities are responsible for most causes of miscarriage.

Harmful Habits To Avoid in the First Trimester

Indiscriminate use of prescription drugs can lead to birth defects. It is important that you check with your care giver before you ingest any prescription drug. Abuse of drugs can be harmful. In poor areas of sub-Saharan Africa, individuals are of the habit of indiscriminately using antibiotics because they lack the financial means to visit proper clinics. Some of the antibiotics are not safe for pregnancy, some are however safe for usage.

Herbal preparations are unpredictable. Herbal preparations that the components are not known are particularly notorious because some of them can cause gastrointestinal symptoms such as diarrhea and in some cases miscarriage.

There are however some safe herbal teas that are known to improve in symptoms such as nausea and vomiting. The beauty of these herbal teas is that their constituents are known and documented.

Alcohol intake in significant amounts can increase the risk of miscarriage. It is also associated with birth defects with associated facial abnormalities and abnormalities of the nervous system. Babies born to mothers who are alcoholic can have problem with growth and development and fail to thrive.

Smoking is associated with increased risk of miscarriage by preventing the developing embryo form implanting into the womb (uterus). Smoking also compromises the supply of oxygen to the embryo. Smokers are more at risk of having premature delivery and premature separation of the placenta a condition known as placenta abruption.

The sad aspect of smoking is that does who don’t smoke but are exposed to smoke probably from their husbands and close relatives are also at risk of all these complications mentioned above.

The implication is that if you live with somebody that smokes, you should advice the person to stop smoking or avoid living in the same environment with that person.

Recreational drugs: Recreational drugs are also referred to as hard drugs and include drugs like marijuana, cocaine, heroin ecstasy etc. They are associated with increased complication in pregnancy such as miscarriage, poor growth of the baby, premature delivery and premature separation of the placenta. They cross the placenta and cause damage to the brain of the baby at birth. They are completely discouraged in pregnancy and outside pregnancy. There are other chemical substances or agents in the environment that one should be cautious of. There is however no strong evidence to support or refute any claim to ill effect caused by this chemical substances. The bottom line is that these substances have to be inhaled in considerable amount or the pregnant woman has to be exposed to them for long duration for them to have any significant harmful effect. Some of the substances include vapor from petrol, glue, cleaning fluids, volatile paints, and household aerosols.

Work-place chemicals that are fat soluble such as pesticides, cleaning agents and some adhesives are capable of crossing the placenta and can be harmful to the pregnant woman. They are better avoided.

Exposure to large doses of x-ray radiation can cause harmful effect to the baby during the first trimester. X-rays are generally not encouraged in the first trimester but the doses of x-ray radiation emitted by modern machines are quite small and may not have any significant ill-effect.

Serial ultrasound scans does not have any negative effect on the fetus. Several studies have been done that has so far demonstrated that ultrasound is safe and without complication. The transvaginal probe that is useful in detecting early pregnancy complications is safe and does not cause miscarriage as erroneously thought by some pregnant women.

Exposure to disease causing agents at this stage of development may or may not affect the development of the baby. It depends on the type of organism involved, the severity of the disease process and the immune status of the mother. The common cold is not infrequent in pregnancy and is mostly associated with rhinorrhoea (catarrh/cough) but it is mostly innocuous and does not have any significant negative effect on the developing baby.

Beyonce spotted with a huge baby bump! Some haters brand her as “fat as hell”

Beyonce may be one of the most famous women on this earth, but that doesn’t stop some detractors from slating her appearance at every opportunity.

And now the expectant singer has found her fanbase is loyal to the end, as they’ve been taking down cruel trolls who have branded her “fat”.

In new pictures showing Beyonce – who is pregnant with twins – leaving a showbiz party in Hollywood last night, the singer looks happy and healthy as she smiles at the awaiting paps.

But wait, there’s more!