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Preconception folic acid — MCCQE Part 1 MCQ

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EasyPreventive MedicinePreconception folic acidMCCQE Part 1

29-year-old woman presents with planning pregnancy. She has no seizure disorder or prior neural tube defect pregnancy. Which of the following is the most appropriate next step?

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Correct answer: D — Recommend folic acid supplementation before conception and in early pregnancy

Recommend folic acid supplementation before conception and in early pregnancy is best because folic acid reduces neural tube defects when started preconception. Discharge without pregnancy-specific safety-netting is suboptimal because pregnancy-related bleeding, pain or hypertension can deteriorate quickly; Perform a digital vaginal examination before excluding placenta previa or instability is suboptimal because digital examination can precipitate haemorrhage when placenta previa is possible; Use a medication contraindicated in pregnancy as first-line therapy is suboptimal because maternal treatment must account for fetal safety and gestational age; Delay obstetric or gynaecologic consultation despite red flags is suboptimal because specialist involvement is needed when maternal or fetal risk is present. Higher doses are reserved for higher-risk groups.

Reference: SOGC neural tube defect guideline