G2P1L1 non consanguineous marriage. 18 weeks usg spinal dysraphism terminated yesterday. how to proceed for her next pregnancy

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Wonderful case of open Neural tube defect. That's why imp of folic acid before preg & during preg . Would have been able to avoid Even early USG at 11 wks & 14 wks would have been able to diagnose early. Needs karyotyping if taken folic acid as per norms. Even h/o consanguinity is one of the facAs such pt in perimemopausal hardly requires any lab tests Unless she is diabetic, EHT, impairment thyroid, breast lump,diagnosed case of ca CX ,ovarian or endometrial ca. After 40 + oestrogen starts declining making females lethargic and somewhat ugly looking by deposition of fat There is mood elevation, depression, anxiety sleeplessness ,insecurity ,dry vagina & irritability. so u can very well put her on low doses of oestrogen & isoflavons. Add Soya milk or soya flour in regular food. Diet rich in minerals & cal,d3. as well b/c& folic.tor. Thanks dr Suvarchala for posting this.

Sorry ans of another post is merged with this post, as net was very slow.
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SPINAL Dysraphism, is NTD. Neural Tube Defect are mainly due to FOLIC ACID DEFICIENCY. History of Consanguinity +. Needs Genetic testing of both Parents to Confirm other one or both Parents carrying the Gene. Apart from FOLIC ACID SUPPLEMENT S.

its NTD... depends on many factors including genetics, maternal health, mat drugs, mat substance abuse & folic acid defi.... ask mother for strict antenatal care, tripple test... start folic acid tab asap bcoz we & even pt cant predict when would she conceive...

Now for next preg Karyotyping of this foetus or both the partners. If reports normal then supplementation of folic acid & b.c ,zinc to mother before conception & mainly during 1st trimester of preg. Routine ANC visits,regular Nt scan (thickness ) in 11 wks double marker at 14 wks. triple marker bet 13 to 17 wks Routine screening for thyroid, DM,autoimmune, ACA, Homocystine hb% prior to preg.

Folic acid @5mg/day and not the usual 0.4mg/day must be started at least 1 month prior to conception. (Nelson 20th edn) in addition prenatal screening in form of MS-AFP and AchEsterase levels along with the usual 2nd trimester anomaly scan must also be done.

treatment based on neural tube defect.. supplement 4mg oral folic acid 12 weeks prior to next conception till 2 weeks later.. correct iron deficiency..

1. Tab. folic acid @5mg per day 1 month prior to the conception to prevent any neural tube defect as well as healthy diet to be taken... 2. calcium n d3 levels to be checked and supplements to be added.. 3. genetic screening of both parents in keeping mind of consanguity... 4. Tiffa scan to be done in detailed @ 18 weeks to rule out any congenital defects.... thankyou mam for sharing this case...

spinal dysplasia a NTD. Due to folic acid deficiency. prophylactic folic acid 5 mg OD must be given 1 month prior to commencement of pregnancy. .

Recurrence of NTDs in her next pregnancy is now 2%.She needs therapeutic dose of folic acid 5mg starting 3 months before conception. And screening in her next pregnancy shud start by first trimester itself

a natural tube defect baby. need to patient education food. nutrition. iron. vitamins overall healthcare.

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