RARE CASE OF RECURRENT NEURAL TUBE DEFECTS IN A OBESE WOMAN.
Dr Poonam Kumari
, Dr Sakshi Jaryal , Dr Pratibha Gurung
maternal obesity, neural tube defects , spina bifida , recurrent NTDs
ABSTRACT Introduction: Increasing trend of pre-conceptional obesity has also led to adverse reproductive outcomes like subfertility, miscarriage, gestational diabetes, gestational hypertension, preeclampsia, macrosomia, preterm birth, and sudden fetal demise. Furthermore, studies on maternal obesity and birth defects have reported that maternal pre conceptional obesity was associated with an increased risk of neural tube defects. Etiology of NTDs in maternal obesity could be explained by the body distribution of folic acid in women with obesity. A study has showed obesity could influence folate pharmacokinetics in women of childbearing age by reducing serum folate concentration. Spina bifida is the most common neural tube defect. Case report: A 29 year old G4P1021 at POG 19 weeks 2 days with BMI OF 34.6kg/m2 came to show her level 2 scan. She is married for 5 years and her first two conceptions were aborted spontaneously. 1 year later she again conceived and was booked and supervised throughout her pregnancy and told normal, she has spontaneous onset of labour around term and delivered a female child weighing 2400 grams with suspicious looking lesion in lumbosacral region in midline. Baby was refered to tertiary care center and finally was diagnosed and treated as spina bifida occulta at PGI. This time she has conceived after 3 years of previous childbirth she took folic acid post conception and level 1 scan was told to be normal. Dual screen was not done in this patient. Level 2 scan done at 19 weeks showing disappearance of posterior line and soft tissue overlapping in the lumbosacral lesion, but continuity of skin over the lesion maintained. Quadruple test yielded raised maternal serum Alpha Feto Protein level. She choose her further treatment at PGI. Discussion: When a spine defect is detected, it is necessary a neurosurgical counseling with the patient; the risk of recurrence is 2 to 5%. The children with SB may have walking problems, sphincter dysfunction, sexual dysfunctions, skeletal deformities, cognitive disease. The degree of handicap and the survival rate depend on the level of injury, the size of the defect, and the presence of associated anomalies. The lower the injury level, the better the prognosis. The cognitive outcome is related by the presence or absence of hydrocephaly. Altogether about 70% of children with SB will have IQ>80. Conclusion: Most studies conducted on NTDs did not highlight the maternal characteristics of women, as primary focus was on neonatal characteristics. There is still a lack of understanding on maternal characteristics, in particular maternal obesity, in women with NTD-affected pregnancy. There is a need to conduct more studies on the relationship between maternal obesity and neural tube defects in Indian population.
"RARE CASE OF RECURRENT NEURAL TUBE DEFECTS IN A OBESE WOMAN.", IJSDR - International Journal of Scientific Development and Research (www.IJSDR.org), ISSN:2455-2631, Vol.9, Issue 2, page no.501 - 503, February-2024, Available :https://ijsdr.org/papers/IJSDR2402076.pdf
Volume 9
Issue 2,
February-2024
Pages : 501 - 503
Paper Reg. ID: IJSDR_210136
Published Paper Id: IJSDR2402076
Downloads: 000347236
Research Area: Medical Science
Country: hamirpur , Himachal Pradesh , India
ISSN: 2455-2631 | IMPACT FACTOR: 9.15 Calculated By Google Scholar | ESTD YEAR: 2016
An International Scholarly Open Access Journal, Peer-Reviewed, Refereed Journal Impact Factor 9.15 Calculate by Google Scholar and Semantic Scholar | AI-Powered Research Tool, Multidisciplinary, Monthly, Multilanguage Journal Indexing in All Major Database & Metadata, Citation Generator
Publisher: IJSDR(IJ Publication) Janvi Wave
