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Assignment:
Subject: Nursing
NEURAL TUBE DEFECTS (NTD)
We report a case of 25years old multigravida woman with 5 months of amenorrhea with meningomyelocele foetus admitted to labour room for termination. Her history says that she has 6 years of marital life and it was nonconsanguineous marriage. There was history of use of oral contraception for four years after marriage. Regarding her obstetrical history, she underwent induced abortion one and half year back as she was diagnosed as anencephalic foetus at 12weeks. The patient given a history of regular menses. After one year of her induced abortion she again conceived naturally. Ultrasonography was done at 8weeks in which no abnormality was detected. After this she was not regular for her follow up. But at 20weeks she visited OPD for follow up, USG was done and report showed Lumbosacral Meningomyelocele measuring 1.76cm and 0.85cm. According to patient she was not taking the folic acid supplements due to the side effects. Genetic counselling was given to her and her husband and was advised for termination of pregnancy.
Induction of labour was started as per prostaglandin regimen. She delivered dead male foetus weighing about 520gms. Mother was counselled for pre conceptional care and regular follow up in future
GUIDE QUESTIONS:
1. Does the use of contraceptives contributed to NTD? Explain
2. Why do you think the mother did not take Folic Acid? Is this advisable? Support your answer.
3. Based on the given situation, are you in agreement with the termination of pregnancy? Why?
4. How can you support parents with a baby diagnosed of NTD?
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