Preconception check

Teresa, 26, was overjoyed when the home pregnancy test kit showed a positive result. She then made an appointment to see me 3 weeks later.

Before her appointment, I received an urgent call from the husband informing me that Teresa was having severe tummy aches while they were out for dinner.

I rushed to the A&E department to find Teresa in pain on the examination couch.

“There was a sudden pain in my stomach and I felt sick. I vomited and almost fainted,” she recalled.

She was sweating. Her blood pressure was slightly low, her pulse rapid, and her abdomen was bloated and tender to the touch.

Ultrasound examination showed that she was 10 weeks pregnant with a healthy fetus. There was a 5 cm ovarian cyst in the right ovary and the womb was surrounded by some fluid

Teresa had a ruptured ovarian cyst. She was rushed to the operating theatre for an emergency operation .The cyst was successfully removed by the laparoscopic key-hole surgery. She recovered well and had a normal delivery 7 months later.

This case illustrates the importance of preconception check. It involves assessment of a woman's overall health and identifications of risks factors that may otherwise complicate pregnancy. It is essential in ensuring a healthy pregnancy and a healthy baby. If Teresa had the gynaecological assessment before conception, the ovarian cyst would have been detected, removed and a traumatic, emergency operation avoided.

In Singapore, many women do not visit a doctor for preconception check.

Ideally, preconception care should begin a year before conception.

During the check up, you will be asked:

· Your age and the age of your spouse

· Years of marriage

· Gynaecological history, including menstrual regularity, menstrual pain, vaginal discharge, sexual pain, previous contraceptive methods and history of sexually transmitted diseases.

· Lifestyle: smoking and drinking habits

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