Obstetric medicine: preconception care, counselling and imaging risks
Preconception checklist (folic acid doses, iodine, alcohol, smoking, vaccines, carrier screening), optimising chronic disease and switching teratogenic drugs before conception, fetal radiation doses by test and gestation, CT, MRI, gadolinium and iodinated contrast, breastfeeding after imaging, and Aboriginal and Torres Strait Islander and Māori maternal health.
Tier 2Topic overview
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Up to half of Australian pregnancies are unplanned, so every consultation with a woman of reproductive age is a chance for preconception care: folic acid, contraception, medicine review and disease control.
- Folic acid 0.4 to 0.5 mg daily from at least 1 month before conception to 12 weeks; 5 mg for higher-risk women. Iodine 150 µg daily. No alcohol.
- Switch teratogens (valproate, mycophenolate, warfarin, methotrexate, ACE inhibitors and ARBs, isotretinoin) before conception, and get chronic disease quiet first.
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Sources
- Mounjaro (tirzepatide) Australian Product Information, sections 4.5 and 4.6 (oral contraceptives; stop at least 1 month before a planned pregnancy)AU/NZmedsinfo.com.au (sponsor Product Information), October 2026
- Ozempic (semaglutide) Australian Product Information, section 4.6 (stop at least 2 months before a planned pregnancy)AU/NZmedsinfo.com.au (sponsor Product Information), November 2026
- MBS item 715: health assessment for Aboriginal and Torres Strait Islander peopleAU/NZAustralian Government Department of Health, Disability and Ageing
- Australian Pregnancy Care Guidelines (preconception, lifestyle, screening)AU/NZLiving Evidence for Australian Pregnancy and Postnatal Care, funded by the Australian Government Department of Health, Living guideline, 2024 onwards
- Pre-pregnancy counselling (C-Obs 3a) and Vitamin and mineral supplementation in pregnancy (C-Obs 25)AU/NZRoyal Australian and New Zealand College of Obstetricians and Gynaecologists
- Australian guidelines to reduce health risks from drinking alcoholAU/NZNational Health and Medical Research Council, 2020
- Australian Immunisation Handbook (pregnancy and planning pregnancy)AU/NZAustralian Technical Advisory Group on Immunisation, Department of Health, Online, current November 2026
- Australian categorisation system for prescribing medicines in pregnancyAU/NZTherapeutic Goods Administration
- Australia's mothers and babies (smoking during pregnancy)AU/NZAustralian Institute of Health and Welfare, 2023 data
- National Agreement on Closing the Gap (target 2, healthy birthweight)AU/NZAustralian Government and Coalition of Aboriginal and Torres Strait Islander Community Controlled Peak Organisations, 2020
- Guidelines for diagnostic imaging during pregnancy and lactation (Committee Opinion 723)American College of Obstetricians and Gynecologists, 2017
- Iodinated contrast media guideline, and gadolinium contrast guidanceAU/NZRoyal Australian and New Zealand College of Radiologists
- Association between MRI exposure during pregnancy and fetal and childhood outcomesRay JG, Vermeulen MJ, Bharatha A, et al. JAMA 2016;316:952-61, 2016
- Pregnancy and medical radiation (ICRP Publication 84)International Commission on Radiological Protection, 2000
- Last updated
- 14 November 2026
What changed
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