Case Study 4
Felicity is a very busy 29-year-old woman in a professional career. She has diabetes mellitus, and is also pregnant for the first time. Due to her busy schedule, it took her three weeks to visit the family doctor to have the pregnancy confirmed. Felicity became very concerned when her physician asked whether she had been taking folic acid. It was all Felicity could do to remember to manage her insulin levels, and taking folic acid supplements was something she hadn’t even considered. Her doctor told her to take 600 μg of folic acid daily and advised Felicity to return later for maternal serum marker testing.
1. Explain the potential teratogenic effect of folic acid deficiency on the developing fetus. What other risk factor is noteworthy in Felicity’s case?
2. What is the benefit of maternal serum marker testing? What other test would be particularly useful to monitor the development of Felicity’s baby in this situation?
3. When is the fetus most vulnerable to the effects of teratogens and why?
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