HOW TO USE Dr Google

We joke about it, but we all do it … google our health concerns. If you don’t know what you’re doing though, health information on the internet can be downright harmful. Navigate with care.

You are trying to conceive – you may even be pregnant already, without knowing it.

How exciting! But did you know you should visit your gynaecologist even while you’re trying to get pregnant, to get as ready as you can be for the day that sperm meets egg?

Most of us know about taking folic acid and a pregnancy multivitamin, attaining a healthy weight, not smoking or taking drugs, eating well and exercising, but there is one more thing to do: you should also check your immunity against certain diseases that are dangerous to foetuses, as well as undergoing screening via blood tests for inherited conditions if they run in your family. So you need to see your doctor IRL.

HIV

It is crucial that you know your status before becoming pregnant. Doctors no longer consider HIV a death sentence, but rather a manageable chronic illness if properly medicated. All pregnant women will routinely have a blood test to determine their HIV status, whether under private or government antenatal care. Your baby’s chances of contracting the virus are minimised if you follow the government’s prevention of mother-tochild transmission programme (PMTCT) guidelines to the letter. You can ensure that your viral load is undetectable by taking ARVs before conception, and you can further protect your baby by ensuring you get good antenatal care during your entire pregnancy and after delivery. And don’t worry too much if you get diagnosed late. “Even late intervention can keep babies infection-free,” says Johannesburg gynaecologist Dr Nirvashni Dwarka.

“If you start receiving care at 34 weeks pregnant, we still have a good chance of protecting the baby.”

RUBELLA

Rubella (German measles) is a mild viral illness that causes a sore throat, swollen glands and a rash, but it is dangerous for pregnant women. Congenital rubella syndrome is very dangerous for unborn babies and can cause deafness, cataracts, and abnormalities in the baby’s heart, lungs and brain. A pregnant woman with rubella is also more likely to miscarry. The risk is highest in the first trimester. The safest thing to do is to visit your gynaecologist before you become pregnant and do a blood test to determine if you have rubella antibodies, Dr Dwarka says. If not, then have a rubella vaccine before conception (and do not conceive for 28 days after having had the vaccine) to protect your baby once you become pregnant. You may need a booster shot even if you had the vaccine in childhood. “But don’t have the vaccine if you are or may be pregnant,” she adds.

If you are accidentally vaccinated while pregnant, don’t stress – there is no strong evidence that this will be harmful, says gynaecologist Dr Bronwyn Moore.

HEPATITIS B

A blood-borne liver disease, hepatitis

B is sexually transmitted and can also be transmitted to a foetus. A vaccine against the disease is included in the SA government’s vaccination schedule, so if you were vaccinated as a child, you should be protected. All healthcare workers should also be vaccinated. “Routine early pregnancy blood tests check for hepatitis B, syphilis and HIV,” Dr Dwarka says. If you are positive for hepatitis B and pregnant, your baby will likely be treated via immunisation shortly after birth, and his liver function will be monitored – but the safest of all is to ensure you are free of the illness and vaccinated before you become pregnant.

CHICKEN POX

“If you have a reliable history of having had chicken pox, we can assume you are immune,” Dr Moore says, “but you can have a pre-pregnancy blood test and be vaccinated if you are not immune. The most dangerous time for varicella (chicken pox) is in the weeks around the delivery.” If you do develop chicken pox at that stage, you and your baby will need to be treated.

SYPHILIS

Whether you are wanting to become pregnant or already are, a syphilis infection can be successfully treated with penicillin in pregnancy.

This sexually transmitted infection is dangerous to the foetus, which is why it is routinely screened for during antenatal care.

HEREDITARY CONDITIONS

“You won’t automatically be tested for hereditary conditions such as sickle cell anaemia or thalassaemia, which are both genetic causes of anaemia,” Dr Dwarka says, “unless you know there is a genetic condition in your family or your cultural group is particularly prone to them.” Tay Sachs disease, for instance, occurs specifically among Ashkenazi Jews, and thalassaemia is a concern for our Greek population. But while you’re pregnant, you’ll have a routine haemoglobin test of iron levels.

RHESUS FACTOR

A blood group test is performed on all pregnant women to check whether they are rhesus negative, in which case a rhesus immunoglobin shot will be given to prevent rhesus sensitisation, which can occur during the delivery as your blood comes into contact with the baby’s (and which then poses a danger in future pregnancies). If you are negative, and your partner is positive, then your child could inherit either. If the baby is positive and their blood makes its way into your bloodstream and mixes with the negative (rhesus sensitisation), it could cause problems. The blood might create antibodies to attack this foreign blood. To avoid this, a rhesus immunoglobin shot will be given to prevent rhesus sensitisation.

“In the ideal setting your prepregnancy screening tests are an Hb for anaemia, a blood group and rhesus test, RPR for syphilis, HIV, Hep B carrier, rubella immunity, varicella immunity, and TSH to check your thyroid function,” Dr Moore says. Under government healthcare you will have some of these tests (Hb, blood group, rhesus, syphilis, HIV), and only once already pregnant.

COVID-19

Should you vaccinate? Ask your doctor. We’re going to say it again: Ask your doctor! Research is ongoing regarding the coronavirus and pregnancy, and your doctor should be your first and last port of call to get the most up-todate information. ●