I would like a preconception check-up - Porodnice U Apolináře

Domů I would like a preconception check-up

Complications During Pregnancy and Childbirth

Prekoncepční ambulance

Alongside our Clinic for Women with Recurrent Pregnancy Loss (preconception), we also monitor women after complicated pregnancies (such as HELLP syndrome, TMA, early preeclampsia before 32+0 weeks, early FGR before 32+0 weeks, FM, PAS) at our clinic.

If you are interested in guidance on planning another pregnancy after previous complications during pregnancy and childbirth, and need preventive examinations and advice from our specialists, please visit our specialized consultation clinic.

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Recurrent Pregnancy Loss

tehotenska.ambulance@vfn.cz

Preconception Clinic

Currently, our preconception clinic offers care to women with a history of severe recurrent pregnancy loss, preterm birth before 34 weeks, and stillbirth. In cases of miscarriage (spontaneous or missed), we focus on women with a history of three or more first-trimester losses (before 12+ weeks) or two or more losses, with at least one in the second trimester (after 12+ weeks).

These women are offered immunological testing, which may or may not reveal a predisposition that significantly increases the likelihood of recurring pregnancy complications. Women who have experienced only two first-trimester miscarriages are not offered care (including immunological testing) at the preconception clinic, and we kindly ask that they do not contact us for this purpose. Care in these cases can be managed by a general gynecologist, who may recommend excluding congenital uterine abnormalities (hysteroscopy/laparoscopy) and thyroid function testing. However, if the treating gynecologist does not offer these, women can contact our clinic with a positive pregnancy test at [tehotenska.ambulance@vfn.cz](mailto:tehotenska.ambulance@vfn.cz)—preferably on Tuesdays and Thursdays—and we will advise on pregnancy support with the medications indicated below. Planning delivery at our maternity hospital is required.

For women with the severe complications described above, after completing testing, we will discuss the next steps. Even if immunological test results are negative, the minimum standard of care for subsequent pregnancies includes low-molecular-weight heparin and progesterone.

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Principles of Diagnosis and Treatment

Among the most significant causes of severe pregnancy complications and pregnancy “losses” is improper communication between the mother’s immune system and the fetus. At our clinic, you will first undergo an examination, and if we rule out other causes of pregnancy complications—such as systemic diseases or abnormal uterine anatomy (congenital anomalies, fibroids, etc.)—we will offer immunological testing. Immunology can reveal various disorders which, in the vast majority of cases, do not threaten your life but can have a major impact on the success and course of the pregnancy.

If the immunological test results are unfavorable, we will propose a set of measures that significantly improve the chances of a successful pregnancy. One of these is an immunomodulatory approach, where the woman self-administers low-molecular-weight heparin (subcutaneous injections) and progesterone (vaginal tablets) daily from early pregnancy.

If the situation is more complex and the immunological findings are abnormal, the patient will be referred for consultation with a reproductive immunologist. In addition to the standard measures, the specialist may recommend further highly effective immunomodulatory treatments, such as intramuscular or intravenous immunoglobulin therapy.