High-dose folic acid — DFSRH MCQ

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HardReproductive HealthHigh-dose folic acidDFSRH

A 34-year-old woman with type 1 diabetes plans pregnancy and asks about preconception supplements. She is not taking antiseizure medication. What would you advise this patient?

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Correct answer: A — Take folic acid 5 mg daily before conception

The best answer is “Take folic acid 5 mg daily before conception”. Diabetes is an indication for high-dose folic acid 5 mg preconception and in early pregnancy. Standard 400 micrograms is insufficient for this risk group. Optimising glycaemic control and medication review are also important. The correct decision follows only after combining the stated timing, competing risks, patient preference and follow-up requirements. The alternative actions are reasonable in neighbouring clinical situations, but they do not fit all of the discriminating facts in this stem. The cited UK guidance governs both the immediate action and the safety-netting that follows.

Reference: NICE NG140, Abortion care: https://www.nice.org.uk/guidance/ng140/chapter/Recommendations