Folic acid supplementation for pregnant women can prevent neural tube defects in the fetus; the picture is a situational photo, and the characters in the picture are not related to this article.

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[Health Channel/Comprehensive Report] A 21-year-old foreign spouse was found by a doctor during a 14-week pregnancy check-up that the fetus had an incorrect head shape, the skull disappeared and the entire orbit became significantly raised. It looked a bit like a frog, which was in line with "anocranial deformity" The fetus was diagnosed with abnormal fetal diagnosis (or "anencephaly"), the doctor suggested termination of the pregnancy, and suggested that the external partner supplemented with folic acid for a long time, and successfully conceived again one year later, and gave birth to a healthy baby.

Wang Peizhong, director of the Obstetrics and Gynecology Department of Chiayi Christian Hospital, shared this case in his new book "The World of Mother and Fetus at a Glance - Perspective of Obstetrics and Gynecology, Part II, High-Level Ultrasound Decryption" (published by Valley Culture and Education).

Please read on...

Wang Peizhong pointed out that the central nervous system is the lifeblood of human beings. It can be said that a single hair can move the whole body. A little mistake cannot be tolerated. Therefore, how to use ultrasound to evaluate its anatomical structure has always been a very important topic.

The central nervous system can be divided into two parts: the brain and spinal cord, both protected by layers of tissue (cerebrospinal fluid, cerebrospinal membrane, skull and spine).

The defect in the protective tissue is commonly known as "neural tube defect", and anencephaly (anencephaly) is one of the neural tube defects.

Ancephaly is not uncommon

Wang Peizhong pointed out that the so-called "anocranial deformity" refers to the error caused by the embryo forming the skull around the 4th week after conception (about 5-6 weeks of pregnancy according to the definition of the last menstrual period).

This deformity is not as rare as the general public thinks, the incidence rate is as high as 1/2000-1/1000, and the actual incidence rate should be higher than that reported in the literature!

Unprotected fetal brain is difficult to survive

Ancephaly is because the brain of the fetus has no protection and is directly exposed to the amniotic fluid. Therefore, if it can be diagnosed early as "ancephaly", the brain tissue can still be seen; if it is diagnosed in the middle and late pregnancy, the brain tissue is already Washed out by amniotic fluid, it became a diagnosis of "brainless child".

In other words, these two deformities are actually the same disease, just the difference in the time of diagnosis.

Because the fetus in this condition is non-viable, once the diagnosis is established, termination of the pregnancy is generally recommended, regardless of the week of pregnancy.

Identifying causative factors may prevent recurrence in the next child

Will the next child be pregnant with an "anocranial deformity" again?

Wang Peizhong pointed out that most of the diagnosed neural tube defects are not inherited, that is to say, they have nothing to do with "good" or "bad". Unless the pregnant woman has neural tube defects (very rare), it is generally Occurrence can be considered purely as "bad luck". The chance of the next occurrence is still slightly higher than that of pregnant women who have never given birth or have given birth to a normal child, but it is still very low.

Of course, some are caused by teratogenic fetuses, such as certain anti-epileptic drugs, anti-folate drugs, excessive vitamin A, and the influence of high temperature in the early stage of pregnancy, etc. These factors must be removed to avoid recurrence in the next child. .

Pregnant women to prevent neural tube defects should supplement folic acid

According to formal academic research, what really helps to reduce the occurrence of neural tube defects is folic acid supplementation. Women who want to become pregnant should supplement at least 0.4 mg of folic acid per day, which can reduce the overall incidence of neural tube defects by more than 50% after pregnancy!

Folic acid is water-soluble and excess will be excreted

Some people will worry: "Will there be any adverse effects if you eat too much?" This question is because although the folic acid supplement tablets sold in the market have doses of 0.4mg and 0.8mg, many of them are 5mg, which is recommended ten times the dose.

I would like to remind everyone that taking high doses of folic acid does not have to worry too much.

Vitamin B complex (folic acid or vitamin B9) is water-soluble, and the excess and unabsorbed parts will be excreted in the urine. Even if you eat too much, it is fine, but the urine will turn dark yellow.

Wang Peizhong said, incidentally, low doses are usually more expensive than high doses!

Because the 0.4mg and 0.8mg doses of folic acid lozenges are exclusively for pregnant women (must be at their own expense), while the 5mg dose is used to treat or prevent anemia (health insurance benefits when there are indications) and pregnant women.

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keywords

  • termination of pregnancy

  • folic acid

  • neural tube defect

  • Ancephaly

  • brainless

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