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Gynaecology & Obstetrics General 4b41372e

A pregnant mother presents with history of delivery of a previous child with Congenital Adrenal Hyperplasia (CAH). The best management protocol for the current pregnancy is:

A
To sta prednisolone after establishing whether fetus is affected by Chorionic Villous Sampling
B
To sta dexamethasone as soon as pregnancy is confirmed
C
To sta dexamethasone after determining sex of the fetus by Karyotyping
D
To sta prednisolone after determining sex of the fetus with USG
High-Yield Explanation
CAH is autosomal recessive; if a woman has previously had a child with CAH and again becomes pregnant the same paner, her fetus will have a one in four chances of having CAH. Because the period during which the genitalia of a female fetus may become virilized begins only 6 wk after conception, treatment must be instituted essentially as soon as the woman knows she is pregnant. Ref: Novak's Gynecology 14th edition, Page 1095 ; Medical care of pregnant patient (American college of physicians) 2nd edition, page 298, 299

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