scholarly journals A Fetus with Iniencephaly Delivered at the Third Trimester

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Esra Cinar Tanriverdi ◽  
Ilhan Bahri Delibas ◽  
Zeynep Kamalak ◽  
Berrin Goktug Kadioglu ◽  
Rukiye Ada Bender
Keyword(s):  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defect ◽  
Rare Case ◽  
Recurrence Risk ◽  
Folic Acid Supplementation ◽  
Third Trimester ◽  
The Third ◽  
Planned Pregnancy ◽  
Maternal Risks

Iniencephaly is an uncommon neural tube defect, having retroflexion of the head without a neck and severe distortion of the spine. Iniencephaly is classified into two groups, iniencephaly apertus (with encephalocele) and iniencephaly clausus (without encephalocele). Incidence ranges from 0.1 to 10 in 10.000 pregnancies and it is seen more frequently in girls. Most of the fetuses with this defect die before birth or soon after birth, while those with the milder forms may live through childhood. Recurrence risk is around 1–5%. Family should be offered termination to reduce maternal risks and counseled for folic acid supplementation before the next planned pregnancy. Here we present a rare case of iniencephaly clausus which was diagnosed at 18th week of gestation by ultrasonography and delivered in the third trimester of pregnancy due to rejection of termination.

scholarly journals Homocysteine Is Lower in the Third Trimester of Pregnancy in Women with Enhanced Folate Status from Continued Folic Acid Supplementation

2005 ◽  
Vol 51 (3) ◽  
pp. 629-634 ◽  
Author(s):  
Valerie A Holmes ◽  
Julie MW Wallace ◽  
H Denis Alexander ◽  
William S Gilmore ◽  
Ian Bradbury ◽  
...  
Keyword(s):  
Folic Acid ◽  
Longitudinal Study ◽  
Pregnant Women ◽  
Pregnancy Complications ◽  
Previous History ◽  
Folic Acid Supplementation ◽  
Third Trimester ◽  
Acid Supplementation ◽  
Folate Status ◽  
The Third

Abstract Background: In many countries, current recommendations are that women take a daily 400-μg folic acid supplement from before conception until the end of the 12th week of gestation for the prevention of neural tube defects. Low folate status is associated with an increased concentration of plasma total homocysteine (tHcy), a risk factor associated with pregnancy complications such as preeclampsia. Methods: In a longitudinal study, we determined tHcy and corresponding folate status in 101 pregnant women at 12, 20, and 35 weeks of gestation, in 35 nonpregnant controls sampled concurrently, and in a subgroup (n = 21 pregnant women and 19 nonpregnant controls) at 3 days postpartum. Results: Plasma tHcy was significantly lower throughout pregnancy compared with nonpregnant controls, with values lowest in the second trimester before increasing toward nonpregnant values in the third trimester. Importantly, mean tHcy concentrations were lower in pregnant women taking folic acid supplements than in those not, an effect that reached significance in the third trimester (5.45 vs 7.40 μmol/L; P <0.05). During the third trimester, tHcy concentrations were significantly higher in pregnant women with a history of miscarriage than in women with no previous history (8.15 vs 6.38 μmol/L; P <0.01). Conclusions: This is the first longitudinal study to show that homocysteine concentrations increase in late pregnancy toward nonpregnant values; an increase that can be limited by enhancing folate status through continued folic acid supplementation. These results indicate a potential role for continued folic acid supplementation in reducing pregnancy complications associated with hyperhomocysteinemia.

Drug and Environmental Factors Associated with Adverse Pregnancy Outcomes Part II: Improvement with Folic Acid

1998 ◽  
Vol 32 (9) ◽  
pp. 947-961 ◽  
Author(s):  
Dale P Lewis ◽  
Don C Van Dyke ◽  
Phyllis J Stumbo ◽  
Mary J Berg
Keyword(s):  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defect ◽  
Pregnancy Outcomes ◽  
Folic Acid Supplementation ◽  
Adverse Pregnancy Outcomes ◽  
Effective Dosage ◽  
Factors Affecting ◽  
Acid Supplementation ◽  
Adverse Pregnancy

OBJECTIVE: To provide a comprehensive review of periconceptional folic acid supplementation and factors affecting folate supplementation trials. DATA SOURCES: A MEDLINE search was conducted through December 1997. Additional sources were obtained from Current Contents and citations from the references obtained. Search terms included folate, folic acid, neural tube defect, spina bifida, and anencephaly. STUDY SELECTION: Relevant animal and human studies examining the effects of folate were reviewed. DATA EXTRACTION: Data collected included: type of study, folate dosing, dietary folate intake, serum and red blood cell folate concentrations, type of defect(s) studied, vitamin usage, parental risk factors, factors affecting trial results. DATA SYNTHESIS: Nine key factors have been identified that affect outcomes of folic acid supplementation trials. Daily doses of 0.8 mg decreased the occurrence and doses of 4 mg decreased the recurrence of neural tube defects in randomized clinical trials. Since lower folic acid doses were effective in nonrandomized trials, research is needed to determine the lowest effective dosage. Other benefits involving pregnancy outcome are suggested. CONCLUSIONS: Women of childbearing age should take a daily folic acid supplement to reduce the risk of pregnancies resulting in infants with a neural tube defect and other potential adverse pregnancy outcomes. Further health benefits from folic acid supplementation are reviewed in Part III of this series.

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