UW folic acid 02-17 (1)

Question 1

UW. folic. When need to start?

Answer 1

Folic acid supplementation is recommended starting ≥1 month BEFORE conception as the neural tube closes very early in pregnancy, often before patients are aware of being pregnant.

Question 2

UW. folic. when occurs neural tube closure? weeks

Answer 2

by 5-6 weeks gestation.

often before patients are aware of being pregnant. all patients should begin folic acid supplementation at least 1 month before conception to ensure adequate folate levels

Question 3

UW. folic. eg as was in case 16 weeks: increasing intake at 16 weeks gestation will not benefit this patient because neural tube closure is complete by 5-6 weeks gestation

Answer 3

In addition, increasing the dosage is not recommended because prenatal vitamins contain other components (eg, vitamin A) that are dangerous if taken in excess.

Question 4

UW. folic. prevention of neural tube. folic dose in average risk?

Answer 4

0,4 mg daily

Question 5

UW. folic. prevention of neural tube. folic dose in high risk?

Answer 5

4 mg daily

Question 6

A 21-year-old woman, gravida 1 para 0, at 20 weeks gestation comes to the office for fetal anatomy ultrasonography. Her initial prenatal visit was last week, and she has had no vaginal bleeding, contractions, or leakage of fluid. The patient had not realized she was pregnant because her menses are irregular, typically occurring only once every 2 or 3 months. She has no known medical conditions and takes no medications. Blood pressure is 146/98 mm Hg and pulse is 88/min. BMI is 30 kg/m2. Ultrasonography reveals a large defect in the calvaria and meninges, with only a small cerebellum and brainstem, as seen in the image below. The remainder of the fetal anatomy appears normal. Amniotic fluid volume measures 26 cm (normal: <24 cm). Which of the following maternal factors is most commonly associated with this fetal anomaly?

Answer 6

INADEQUATE FOLATE INTAKE

Question 7

UW. What regulates folates?

Answer 7

Neural tube closure is a tightly regulated process dependent on folate metabolism

Question 8

UW. what is high risk in folate deficiency?

Answer 8

Therefore, inadequate maternal folate intake (folate deficiency) is a major risk factor for NTDs.

Question 9

UW. anencephaly Dx?

Answer 9

Anencephaly is diagnosed by fetal ultrasonography, which typically reveals an absent cerebrum, a calvarial defect, an abnormal cerebellum or brainstem, and elevated amniotic fluid volume (polyhydramnios due to impaired fetal swallowing).

Question 10

UW. anencephaly what amnio?

Answer 10

elevated amniotic fluid volume (polyhydramnios due to impaired fetal swallowing).

Question 11

UW. anencephaly incompatible with life.

other conditions, eg. myelomeningocele, in which the spinal cord and meninges are exposed) may be less severe and compatible with life.

Answer 11

.

Question 12

UW. rubella what pathology?

Answer 12

fetal growth restriction

Question 13

UW. varicella, what pathology?

Answer 13

microcephaly

Question 14

UW. fetal growth restriction (rubella) or microcephaly (varicella) on ultrasonography. Neither presentation is associated with anencephaly.

Answer 14

.

Question 15

UW. STD. syphilis presentation?

Answer 15

hydrocephalus

Question 16

UW. STD. herpes simplex presentation?

Answer 16

microcephaly

Question 17

UW. hydrocephalus (syphilis) or microcephaly (HSV) on ultrasonography. These conditions are not associated with anencephaly.

Answer 17

.

Question 18

UW. toxoplasmosis due to undercooked meat consumption, CP?

Answer 18

microcephaly, hydrocephalus, and diffuse cerebral calcifications on ultrasonography. It does not cause NTDs.

Question 19

UW. Poorly controlled hypertension, as in this patient, increases the risk for fetal growth restriction, placental abruption, preeclampsia, and preterm delivery. It does not increase the risk for NTDs.

Answer 19

.