Doctor Velimir Kuzmanovski, a gynecologist finds that regular visits to chosen gynecologists are of a crucial importance for pregnant women in the first trimester of a pregnancy because, as he explained, a mother’s body adapts to the changes and the fetus develops fast in that period. He added that female patients have check-ups regular for that period of a pregnancy. He pointed out that the patients are recommended an adequate nutrition, multivitamin therapy and microbiologic swabs to prevent from genital infections which can cause a risk of a preterm delivery. Approximately 300 women of Roma ethnicity visited the Private Health Institution Niti from Kumanovo last year for an advice, an examination, a check-up and a therapy. A great number of the female patients of doctor Kuzmanovski follow the doctor’s recommendations for nutrition and regularly receive the therapy given.
Doctor Kuzmanovski said “As far as nutrition is concerned, the food should be rich in vitamins and minerals as well as diverse, and to drink plenty of fluids. Fruits and vegetables, grains, lean meat, fish and dairy products should be consumed. Also, it is important to have several light meals six to eight times a day.”
Still, he pointed out that there are female patients who do not follow the recommendations carefully because of low monthly family incomes, but a patient’s level of education has enormous influence as well.
Doctor Kuzmanovski pointed “It happens that female patients who come from socially vulnerable families sometimes do not visit us to be subjected to examinations, but generally our patients follow the recommendations.”
The doctor informed that female patients from the Roma community most often get pregnant at a younger age. He pointed at a 23-year-old patient pregnant for the third time, as an example. He also pointed at the problem of adolescent pregnancy. Still, female patients at a younger age, to 25, usually have an easier pregnancy since they are more vital and have a lower risk of congenital malformations of a fetus.
In the area of supplements in the first trimester of a pregnancy and when a patient plans to get pregnant, it should start to take folic acid and to continue the treatment until the end of the first three months of a pregnancy. Doctor Kuzmanovski finds that this significantly reduces the risk from anomalies in the central nervous system of a fetus. At the same period, while taking folic acid, it is recommended to take multivitamin products for pregnant women specifically, such as, supplements and multivitamins with minerals, calcium, magnesium and omega 3 for development of the fetus brain.
He explained that the risks are specifically related a patient’s age.
Doctor Kuzmanovski stated “The risk is assessed based on a patient’s age, the older the patient who is pregnant for the first time is, the higher the risk is.” He added software examinations are conducted in that case for genetic predispositions of a fetus by indicating to an ultrasound examination between the eleventh and thirteenth week of pregnancy to measure the patient’s level of a risk.
Doctor Kuzmanovski recommended that it is good for all patients who plan to get pregnant to obtain advice from doctors. But, that practice is not adopted in Macedonia.
Doctor Kuzmanovski said “Patients who come before they get pregnant are very rare. No Macedonian women, no Roma women, no Albanian women. They all come after they get pregnant. There is a need for prevention and that is the area to work in more intensively.”