Dear Editor, The need for prepregnancy counseling is being increasingly contemplated and deliberated upon.1,2 Based on this, we propose that there should be a designated preantenatal visit, too, of the mothers-to-be, for preventive, diagnostic, and therapeutic reasons, for example, periconceptional folic acid, diagnosing and treating hypothyroidism, and preexisting maternal disorders such as chronic hypertension, diabetes mellitus, maternal infections, and anemia. There should be battery of tests and examinations for these conditions. We should not wait for conception and pregnancy to take place with these risk factors and then diagnose them in the first antenatal visit. And then give treatment to control the ill effects of them on the health of the mother and fetus/neonates and future children. Unnecessary and preventable congenital anomalies, abortions (both spontaneous and induced), fetal growth restriction, prematurity, and other adverse maternal and fetal effects can be averted to a great degree. Pregnancy will become safer. Teenagers and elderly mothers can also be counseled. It can also extend to contraceptive advice and genetic counseling. This visit can be called as prepregnancy, preconceptional, or zero visit. It should not be confused with prenatal (also known as antenatal or antepartum) visit that means before birth or relating to pregnant women and their unborn babies. Actually, we in developing countries are still grappling with good antenatal, intranatal, and postnatal care; hence, very little emphasis on prepregnancy clinics/care is there. The care has been advocated, but a designated prepregnancy visit is not proposed as yet in either textbooks or by the WHO and others1,2 (although there has been a proposal to have 8 antenatal visits). It is being practiced in tertiary care hospitals, more so with bad obstetric history. We want to emphasize that this visit should take place before 1st pregnancy itself and before every pregnancy. We can call it a zero visit. It is preventive in nature toward adverse health effects and mortality to the mother, fetus, neonate, and progeny in totality. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Gupta et al. (Thu,) studied this question.