TYK231
A woman comes into the OB clinic at 6 weeks gestation for her first visit. She tells you she is concerned about having a child with spina bifida and asks if she can do anything to prevent it? You should tell her:
a) She should begin taking folic acid supplements, since they have been shown to decrease spina bifida by 78%.
b) Not to worry, spina bifida can now be cured by mid-gestational (fetal) surgery.
c) There are many benefits to prenatal vitamins, but they will not prevent neural tube defects for this pregnancy.
d) Neural tube defects are very rare, so she should not worry.
e) Since this is her first pregnancy, the rate of spina bifida should be very low
Answer
Answer c. Folate supplementation has been shown to decrease the incidence of neural tube defects (NTD) by up to 78%; however, the neural tube closes between days 23 and 27 of gestation; at this point in her pregnancy, supplementation will not have any effect on the incidence. Fetal surgery may be able to reduce the risk of VP shunt dependence later in life as well as other benefits, but it does not “cure” NTD. Spina bifida is one of the most common birth defects at 1 in 1,000 live births.
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.