The neural tube defect among newborn can be prevented by providing?

Chitranjjan National Cancer Institute Kolkata - 2021

Obstetrics & Gynaecology

Easy

Appeared in: Chitranjjan National Cancer Institute Kolkata - 2021

Explanation

Neural tube defects (NTDs) are prevented by maternal periconceptional use of folic acid.
The neural tube closes by the 28th day of gestation, which is within the first trimester. Therefore, folic acid must be present during this critical period.
To be effective, folic acid supplementation should be initiated before conception and continued at least through the first 12 weeks of gestation.
The US Public Health Service recommends that all women of childbearing age take 0.4-0.8 mg of folic acid daily.

Option A: Iron supplementation is for the prevention and treatment of maternal anemia; it does not prevent neural tube defects. The third trimester is also well past the window for neural tube formation.
Option C: While iron and folic acid are both important throughout pregnancy, the critical period for folic acid to prevent NTDs is specifically the periconceptional period and the first trimester. Supplementation after this window does not prevent NTDs.
Option D: Vitamin K is not involved in the formation of the neural tube. It is essential for the synthesis of clotting factors.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Prevention of Neural Tube Defects (NTDs) as background academic context rather than a clinical decision trigger.
Preconception counseling is a critical nursing intervention. Nurses should educate all women of childbearing age about the importance of daily folic acid intake, as many pregnancies are unplanned.
Nurses must identify women at high risk for NTDs (e.g., those with a history of a prior NTD-affected pregnancy, diabetes, or on anti-epileptic medication) and ensure they are aware of the need for a higher dose (4 mg) of folic acid before conception.
Patient education should stress that waiting until pregnancy is confirmed is often too late to prevent NTDs, reinforcing the need for consistent supplementation.

How to Approach the Question

Identify the core question: The question asks for the method to prevent neural tube defects (NTDs).
Recall the pathophysiology of NTDs: Remember that NTDs are defects in the formation of the brain and spinal cord that occur very early in embryonic development.
Connect the pathophysiology to the intervention: The neural tube closes by the 4th week of gestation. Therefore, any preventive measure must be in place during this extremely early period.
Evaluate the options based on timing and substance:
Option A (Iron, third trimester): Incorrect substance (iron) and incorrect timing (too late).
Option B (Folic acid, first trimester): Correct substance (folic acid) and correct timing (first trimester covers the critical window).

Concept Tested & Keywords

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