Patient's question:
In April 2013, during the 24th week of pregnancy, an ultrasound examination revealed a neural tube defect in the fetus, and subsequent mid-trimester pregnancy termination (induced abortion) was performed. (The Down syndrome screening did not show any issues.)Folic acid was taken irregularly before pregnancy and continued until around the 8th week.
There is no history of neural tube defects in the family.
At the 8th week of pregnancy, the patient experienced influenza with a low-grade fever of approximately 37.8°C, lasting for about 3 days.
No other medical history is present.
Doctor's answer:
According to our preventive healthcare requirements, you have a history of giving birth to a fetus with a neural tube defect, which makes you a high-risk pregnant woman. This pregnancy should undergo pre-pregnancy prenatal health examination (for both husband and wife) six months before conception. Additionally, folic acid should be taken daily in an amount of 40mg, which is 10 times the original daily dose of 0.4mg. It is important to persist in taking it for more than a month to ensure that the folic acid level in your body reaches a certain level to prevent abnormalities. After taking it for three months, you can continue to take it. It is said to have a preventive effect on congenital heart disease in the fetus. (Currently, there is no official data or papers on the prevention of congenital heart disease, so I can only say it is said.) Therefore, you can continue to take folic acid tablets until delivery or continue to take multivitamin tablets containing folic acid. Common ones include Kingsley Multivitamins, Alerli, Run Kang, etc.If you haven't taken folic acid tablets on time, but your dietary habits are more inclined to the southern Chinese style, with a higher intake of green vegetables, it is possible to obtain some from food. However, the amount is relatively small. This is because dietary folic acid is not heat-resistant and is easily lost during cooking.
The issue of having a low-grade fever during influenza in early pregnancy may increase the risk of the fetus developing congenital heart disease. Whether it will definitely occur is unpredictable.
It is recommended to continue taking folic acid or multivitamin tablets containing folic acid.
Take the pre-pregnancy examination seriously. Between weeks 11-12, undergo NT ultrasound screening and inform the ultrasound doctor that you have given birth to a fetus with a neural tube defect, so they can help you conduct a thorough examination of the NT. After week 13, it is NF. These are the first lines of defense for screening neural tube defects. Then, schedule an appointment with your doctor to directly undergo amniocentesis.