Preconceptional Counselling
Preconceptional Counselling involves a detailed consultation with your doctor who will make sure that you have an uneventful and uncomplicated pregnancy and in a way it is also a good opportunity for you and your partner to improve your own health and identify any health conditions or risks factors that may affect you or your unborn baby before pregnancy. Pre-conceptional counseling health care should be started 3 months before or at least one month before pregnancy for the best and healthy outcome of pregnancy.
Having a safe, happy, and healthy pregnancy begins well before you test positive on your pregnancy test. Unplanned pregnancies may be associated with a greater risk of preterm birth; low birth weight; structural abnormalities or genetic problems in babies. So Preconceptional Counseling is essential that the woman should be healthier before she has a baby on board.
ICD-10 Codes for Preconceptional Counseling:
Preconceptional counseling involves advising individuals on health and lifestyle changes before pregnancy to improve outcomes. Relevant ICD-10 codes include:
- Z31.6: Encounter for preconceptional counseling and advice
CPT Codes for Preconceptional Counseling:
Preconceptional counseling is often part of routine visits or consultations. Relevant CPT codes for this counseling might include:
- 99201 – 99215: Office or other outpatient visits (for evaluation and counseling, depending on the complexity of the counseling session)
- 99401 – 99404: Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (time-based codes that may be used for preventive counseling)
Dr. Dimple Doshi at Vardaan Hospital; believes prevention is better than cure, and thus apart from the precise treatment guidelines; preventive measures are an essential part of our consultations with the patients who have either had it or want to know more about it.
What is Done In Preconceptional Counselling?
- Your detailed history will be taken. This also includes your family history. Your risk of development of genetic or chromosomal disorder will be assessed based on your family history; ethnic back ground; age; career; consanguinity of marriage; and also possibility of diseases like thalassemia.
- You will be asked to do simple tests like CBC; urine analysis, blood type; screening tests for rubella; hepatitis B; HIV; HCV; gonorrhoea; diabetes; chlamydia; cervical cytology. You will be also being counselled and informed about TORCH infections.
- You will be screened for sexually transmitted diseases; urinary or genital tract diseases or periodontal diseases as they all can affect the pregnancy and have effect on the baby.
- Your previous pregnancy outcomes will be precisely noted. Like infant death; foetal loss; birth defects; premature birth; or repeated abortions; genetic defects in previous child etc.; as all these can lead to recurrence in next pregnancy
- You will be asked about your vaccination status of Covid 19; hepatitis B, rubella, varicella , T dap , HPV or influenza vaccine.
- Your hemoglobin level also should be within normal limits to ensure proper health during pregnancy
- Ultrasonography is a very important investigation to rule out any problem or abnormality with your genital tract.
- If you have a medical condition like diabetes; hyprtension or hypothyroidism or cardiac disease; be sure that it is under control before you start planning.
- Your body mass index should be measured. The higher the BMI; the higher the risk of you developing pregnancy induced hypertension and its harmful effects on the baby.
- Exposure to heavy metals, pesticides, endocrine disruptors etc. at home or at work or in the neighborhood should be avoided. What are endocrine disruptors?
— Endocrine disruptors, sometimes also referred to as hormonally active agents that can interfere with endocrine systems. These disruptions can cause cancerous tumors, birth defects, and other developmental disorders in the growing child or growing baby inside the uterus..
— Endocrine disruptors are found in everyday products, including some food and beverage packaging, cosmetics, toys, flame retardants, and pesticides. Your contact with these chemicals may occur through diet, air, skin, and water. Plastics and epoxy resins found in many plastic products, including food storage containers or water bottles. You must try to minimize this by avoiding the toxic elements. Exposure to radiation and toxic gases also should be minimized before planning pregnancy. - You will be screened for depression, anxiety or any major psychological stressors.
- You will be asked to stop; change or modify the dose of certain medications like hormonal pills; vitamin A pills for pimples; epilepsy medicines; diabetes medicines or blood pressure medicines if you are taking them. You will have to consult your physician to change the medicine or modify the dose.
- You will be supplemented with adequate amounts of folic acid in the pre conceptional period. As daily use of vitamin supplements containing folic acid is said to reduce the incidence of birth defects.
- Keep up the good health by reducing the unhealthy food items and relish the right stuff like green leafy vegetables and have colorful diet.
- Avoid stress and practice relaxation and meditation.
- If you do not exercise, try to start a reasonable and regular exercise routine – this has great benefits for pregnancy as well as your general health