Preparing for pregnancy: gynecologist Ana Marbella advices
Interview with Dr. Ana Marbella Muñoz
Nowadays, couples are starting families later in life. Having a baby after a certain age presents more difficulties and risks, that’s why having a medical check-up before pregnancy is necessary in order to have a correct development through pregnancy. We had the opportunity to interview Dr. Ana Marbella, obstetrician and gynecologist, who is very committed in caring for women during its fertile stage, and she explained us the importance of preparing for pregnancy before starting this wonderful phase.
Dr. Ana Marbella Muñoz has a great experience in women care at all stages. She is specialist in obstetrics and gynecology by the ‘Hospital Universitari i Politècnic la Fe’ in Valencia. Currently, she works in the ‘Clínica Medinorte’, ‘Quirónsalud’ and in the ‘Hospital Casa de Salud’ in Valencia.
Do you think it is important for a woman to get a medical check-up before pregnancy? Why?
Prevention and caring for our health in order to improve it and avoid having some pathologies or problems, that sometimes can not be easily treated, is becoming increasingly important. That’s why it’s crucial to spread our knowledge as doctors to preserve people’s health.
Perinatal medicine makes reference to anything related with the care of the fetus inside the uterus, at the time of delivery and the care of the newborn baby. On perinatal medicine, assistance before pregnancy is important to identify the social and medical conditions of both parents that can be detected, and therefore improved, before conception. The objective is to increase possibilities to avoid any problem during pregnancy and make sure both the mother and the baby enjoy good health.
It is important to plan pregnancy?
Nowadays it is inconceivable that a pregnancy isn’t properly planned. It has been demonstrated that the establishment of health-care programs improve the perinatal results. These advices will benefit not just women that present risk factors, but also women who are apparently healthy, and need an adequate medical check-up that confirms it.
It is very important to apply the “all women, all visits” rule in our medical offices. In other words, we need to take advantage of every opportunity to perform promotion of health activities and counselling before pregnancy with our patients.
What actions do you consider more important in counselling before pregnancy?
In first place, we have to conduct a general and gynecologic exploration, which includes a cervical cytology and a breast revision. It is also important to investigate the personal and family reproductive history, the family history of sons who have suffered genetic, chromosomal, estructural (neural tube defects), metabolic or neurological alterations, mental retardations or cystic fibrosis. A study and genetic counselling is crucial in any of these cases.
I don’t want to forget about the breast protection of our patients by investigating the family history, also men’s (breast cancer can also affect men). Sometimes it is necessary to study the possible mutations (BRCA1 and 2 genes) related to this type of cancer.
Why is knowledge of the personal medical history important and how can the couple be counseled for preparing for pregnancy?
Evaluation before pregnancy is necessary in order to evaluate the women of reproductive age. In case of women that suffer any chronic disease, it is our duty to offer information about the possible risks pregnancy may suppose to its disease or vice versa.
We have to place all women in the best health conditions before pregnancy and choose the best moment for pregnancy, we must raise awareness of patients with chronical diseases through a counseling from both the specialist doctor and the gynecologist that is going to take control of its pregnancy.
Which diseases do you consider need a better counselling?
The list may be very long, but I will mention the most frequent ones in women of reproductive age:
- Diabetes Mellitus. The good perinatal state will depend on complying with all the tips and practical medical information. Pregnancy will be advised just if the glycated hemoglobin levels are correct and without any severe complication (nephropathy, ischemic cardiopathology, proliferative retinopathy or also in severe autonomic neuropathy).
- Women also must be informed in case of arterial hypertension, epilepsy, cardiovascular disease, asthma, thromboembolic diseases, thrombophilia, connective pathologies, hypo and hyperthyroidism, psychiatric disorders… A previous evaluation before pregnancy is required in order to transmit the patient when is the ideal moment to get pregnant and, sometimes, modify the treatment for the disease.
- In relation to cancer, I must do a specific consideration, as it is more common to find women of reproductive age that survive a neoplastic process. It is important to know that before neoplasm, women must be counselled about preserving her fertility in light of the possible damage the ovary may suffer with the hormonal treatments such as chemotherapy and radiotherapy. Genetic counselling in relation with possible oncogenic mutations is important.
We hope Dr. Marbella’s advices have been useful in order to know how to prepare for pregnancy and make the dream of being parents come true.