Question

A routine prenatal ultrasound reveals a male fetus with a meningomyelocele. The 24-year-old primigravid mother is told the infant will require surgery shortly after birth. You counsel her about the etiology of this defect and the risk of further pregnancies being similarly affected, and state which of the following?

A) The condition is autosomal recessive
B) Diagnosis can be made by low levels of alpha-fetoprotein in amniotic fluid
C) Supplement maternal diet with folate to decrease incidence of this condition
D) Neither environmental nor social factors have been shown to influence incidence

Answer 1

The counseling for the mother should focus on the recommendation to supplement her diet with folate to decrease the incidence of neural tube defects like meningomyelocele in future pregnancies. Folate supplementation is known to reduce the risk of such defects by a significant margin.

Step-by-step explanation:

A routine prenatal ultrasound has revealed that a male fetus has a meningomyelocele, which is a form of spina bifida. This is a birth defect of the spinal cord that occurs when the neural tube does not completely close, resulting in meninges and neural tissue emerging through the vertebral column. To answer the question posed, supplementation of the maternal diet with folate during pregnancy is recommended to decrease the incidence of neural tube defects such as spina bifida.

Environmental factors, such as maternal nutrition and exposure to certain substances, do indeed play a role in the incidence of neural tube defects. Hence, while the exact etiology of spina bifida involves both genetic and environmental factors, the specific recommendation for preventing recurrence in subsequent pregnancies is to increase maternal intake of folate, which has been shown to significantly reduce the risk of these birth defects.