Which of the following drugs are to be prescribed in first trimester of pregnancy?

PGIMS Rohtak NO - 2017

Obstetrics & Gynaecology

Easy

Appeared in: PGIMS Rohtak NO - 2017

Explanation

Folic acid is critically essential from the pre-conception period through the first 12 weeks of pregnancy to prevent neural tube defects (NTDs) like spina bifida.
Iron supplementation is also recommended to begin early in pregnancy to prevent maternal iron-deficiency anemia and support the growing needs of the fetus and placenta.
Guidelines from the World Health Organization (WHO) and national health programs (like India's Anemia Mukt Bharat) advocate for combined Iron and Folic Acid (IFA) supplementation starting as early as possible in pregnancy.
Prescribing both together in a combined tablet is a standard, comprehensive approach that improves patient adherence and addresses two major health concerns simultaneously.

Option A: This is incorrect because iron is never prescribed alone in the first trimester without folic acid. Folic acid's role in preventing severe birth defects is non-negotiable during this period.
Option B: While folic acid is absolutely essential, this answer is incomplete. Standard practice, as per WHO and other guidelines, often involves prescribing a combination of iron and folic acid from the start of pregnancy.
Option D: This is incorrect. Nutritional supplementation, particularly with folic acid, is a fundamental and evidence-based component of antenatal care to prevent serious complications.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Antenatal supplementation in the first trimester of pregnancy as background academic context rather than a clinical decision trigger.
Nurses play a vital role in educating pregnant women about the importance of adhering to their prescribed supplements to prevent both birth defects in the baby and anemia in the mother.
Patient counseling should include tips for managing common side effects of iron, such as nausea (take with a small snack) and constipation (increase fluid and fiber intake).
What if? If a patient experiences severe nausea and vomiting (hyperemesis gravidarum) in the first trimester, a healthcare provider might temporarily advise taking only folic acid and reintroducing iron in the second trimester when nausea typically subsides.

How to Approach the Question

First, identify the core of the question: what supplements are standard prescription in the first trimester of pregnancy.
Evaluate each option's role. You know Folic Acid is essential for preventing neural tube defects early on.
Consider Iron. While its demand peaks later, think about preventative health. Is it also given early to prevent anemia?
Analyze the option 'Both of the above'. In multiple-choice questions, if two options are correct and a combined option exists, the combined option is often the most complete answer.
Recall or deduce that combined Iron-Folic Acid (IFA) tablets are a very common public health intervention started early in pregnancy.
Conclude that 'Both of the above' is the most accurate answer reflecting comprehensive antenatal care guidelines.

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