THE IMPORTANCE OF PRE-MARRIAGE PRECONCEPTIONAL CARE AND THE COUNSELING ROLE OF MIDWIVES

Introduction: Preconceptional care is an important opportunity to identify risk factors affecting the pregnancy process and to provide appropriate care. In this study; it was aimed to provide preventive health services related to reproductive health to couples who applied for marriage and to emphasize the importance of midwives in preconceptional care services. Method: The population of the descriptive study consisted of couples who applied to Izmir Bornova Municipality Marriage Office between June 15, 2016 and June 15, 2017. Sample selection was not made, all couples who agreed to participate and were given counseling formed the sample (n: 126). Data were collected through a questionnaire using face-to-face interview method, and their analyzes were presented in the SPSS 20.0 package program by making a percentage distribution. Results: The average age of women is 26.0±4.0 (min:18.0-max:42.0). It was determined that 91.2% of the participants planned pregnancy after getting married. 42.6% of those planning pregnancy use cigarette, 33.9% use alcohol, only 20.9% exercise regularly. 96.0% of the participants stated that consultancy should be given before getting married, 30.2% of them stated that this training should be given by experts and 19.0% by midwives. Discussion and Conclusion: In our study, where we evaluated the application for marriage as an opportunity and offered preconceptional counseling, it was determined that the participants planning pregnancy had risky lifestyle behaviors and wanted to receive formal training from experts. It is thought that preconceptional counseling, which will be given by midwives by expanding its scope within the scope of primary health care services, will contribute to harmony in marriage and the formation of healthy generations.

Acrochordons and autoimmunity: Significance of preconceptional counseling

BACKGROUND: Acrochordons are benign hypertrophic lesions of the skin of which the pathophysiology is unclear. OBJECTIVE: This study aimed to examine the association of acrochordons with autoimmune disorders in patients with a poor obstetric history. METHODS: This retrospective cohort involved 350 female patients with poor obstetric history who were included in a preconceptional care program to investigate risk factors for obstetric complications. These patients were further investigated for the co-existence of autoimmune disorders (defined by either a diagnosis of autoimmune diseases or autoimmune antibody positivity) and acrochordons. RESULTS: An autoimmune disorder was present in 55.7% (195/350) of the patients. The rate of acrochordons was significantly higher in patients with autoimmune disorders (n= 195) compared to the control group (n= 155) (8.21% versus 2.58%, respectively) (p= 0.043). When the autoimmune disease positive (n= 58) and autoimmune antibody-positive (n= 137) groups were separately analyzed, acrochordons were found more frequently in the autoimmune disease group (p= 0.004). However, there was no statistically significant co-occurrence of autoimmune antibody positivity and the presence of skin tags (p= 0.135). CONCLUSION: There may be immune system-related biological mechanisms underlying the pathogenesis of acrochordons. Preconceptional counseling is beneficial for women with poor obstetric history and acrochordons.

Proper Use of Inflammatory Bowel Disease Drugs during Pregnancy

Crohn's disease and ulcerative colitis, referred to as inflammatory bowel disease (IBD), are chronic, relapsing conditions. Patients are often diagnosed at a reproductive age, and therefore questions about fertility and reproductions often arise. Preconceptional counseling is the most important aspect in the management of IBD patients with a pregnancy wish. Patients should be counseled on the influence of IBD and IBD drugs on pregnancy. Most drugs are not related to adverse outcome while used during pregnancy. Active disease is related to adverse outcomes; therefore, it is of utmost importance to strive for remission before conception and during pregnancy.