● Pre-pregnancy counseling
Pre-pregnancy counseling means visiting a gynecologist to assess your current health status,
Your previous history of pregnancy and childbirth, your medical history and social behaviors and
anything that may affect your fertility as a couple.
The gynecologist may ask questions about your diet and lifestyle, as well as your family history
of illnesses.
These assessments may also include physical examinations and tests, ultrasound and Pap
smear.
You can prepare yourself physically and mentally in pre-pregnancy counseling sessions with the
guidance of specialists and be well-educated about all the necessary steps before pregnancy.
Specialists provide useful information on how to properly monitor menstrual periods, appropriate
times for sexual intercourse, and pregnancy testing.
They will provide you with the vitamins and nutrients your body needs, diet tips and exercise.
Prenatal counseling is necessary for every woman who is planning to become pregnant, but
some women need it more than others.
-Women who have never experienced any pregnancy or childbirth.
-Women who, themselves or their spouse, have a specific disease or medical condition.
-Couples who have a history of diseases and physical problems in their family members.
-Women who have had problems in previous pregnancies and deliveries, themselves or their
babies, or have not been able to complete a successful pregnancy.
-Couples who have experienced recurrent miscarriages.
● Prenatal care
Prenatal care includes care provided by a gynecologist and midwife during your pregnancy time
to ensure that you and your baby are in the best possible health status and that your pregnancy
is terminated in the best possible way.
These cares are provided through regular sessions during the ninth month of pregnancy and
include the following:
-Assessment of the health status of you and the fetus through physical examinations, hearing
the sound of your fetus's heart, measuring weight and blood pressure, performing paramedical
tests, ultrasound, fetal ECG, etc….
Each person needs nutritional recommendations, weight control, exercise, and dietary
supplements during each trimester of pregnancy according to her own situation.
-The caregiver provides information on delivery methods , suggestions for attending prenatal
visits and breastfeeding preparation classes.She or He answers all your questions about
pregnancy and childbirth.
-Your counselor also asks you multiple questions regarding domestic violence, sexual abuse or
mental health problems and refer you to relevant consultants and experts if necessary.
● Cerclage
Cervical stitching and suturing during pregnancy is called cerclage, and is needed in cases with
cervical insufficiency which pregnant mother is at risk of miscarriage or premature birth .
It is done by a surgeon and gynecologist to maintain and continue the pregnancy .
When the opening and thinning of the cervix occurs, cerclage helps to close the cervix and
reduces the risk of miscarriage and premature birth. In 80-90 % of cervical insufficiency cases
,cerclage is effective in preventing abortion.
It can be done in the early second trimester of pregnancy and after week 12, but in special
circumstances it can be done up to 24 weeks of pregnancy.
It is better to perform cerclage after the first stage screening tests and after ensuring the health
of the fetus.
Possible side effects:
Infection
Damage to the bladder
Damage to the cervix
Bleeding
Rupture of amniotic sac
Cerclage is a small operation performed in the operating room under general anesthesia or
spinal
anesthesia.
It takes less than an hour.
This operation is performed both in the abdomen and vagina, but the usual method is vaginal.
If you have had a premature birth or a second trimester abortion in your previous pregnancy, or
if you have a decreas in cervical length in your current pregnancy, or you have signs of a
miscarriage or premature birth, according to the obstetrician. They will offer you a cerclage.
If you have any of the following conditions, you should let your doctor know early in the
pregnancy and at the first appointment.
-Miscarriage in week 16-20 of pregnancy.
-Premature birth before the 24th week of pregnancy.
-Rupture of the amniotic sac before 37th week of pregnancy.
-History of cryotherapy or any type of surgery on the cervix such as cone biopsy.