The unlived life is not worth examining -Sheldon Kopp

Preventing Birth Defects

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As she walked out of the new born unit, my mind drifted back to the phone call I had heard her make…”it is just a small swelling on her back. Something that will definitely close on its own ….” her words kept going round and round in a circle in my mind; just small swelling on her back, something that will definitely close on its own, just a small swelling on her back, something that will close on its own, just a…. I had spent at least one hour explaining to her that her baby girl had spina bifida, a neural tube defect that would need surgery. I had told her that even after surgery, her child would still have problems with movement, and bladder and bowel continence. I had thought she had understood but when I heard her making that phone call, I kept wondering; if she was she still in shock or she had chosen to be overly optimistic, or if she was just trying to re-assure another person, or if she was just being a mother and thinking best thoughts for her child.

No woman carries a pregnancy to term expecting to give birth to a less than perfect child. The shock that normally comes with realizing that your child is ‘not perfect’, that your child has a birth defect is therefore understandable. Being that January is “the National Birth Defects Prevention month”, I would be happy if you took some time off to read a little about preventable birth defects.

Here are some of the causes of preventable birth defects:
 ALCOHOL-
No amount of alcohol is safe to drink while pregnant.
Drinking alcohol while pregnant may result in; FETAL ALCOHOL SPECTRUM, a disorder characterized by; 1. Facial anomalies; small head circumference, small eye opening, flat upper lip
2. Intra-uterine growth restriction and poor weight and height gain after birth and
3. Learning or behavioral abnormalities.
People who are planning to conceive should therefore refrain from drinking and stay alcohol free throughout the pregnancy.

 FOLIC ACID DEFICIENCY
Pregnant women are usually given folic acid supplements throughout pregnancy.
Folic acid deficiency may lead to neural tube defects such as spina bifida and anencephaly
Ideally, women who are planning to conceive should prepare for conception by starting to take their folic acid tablets at least three months prior to conception.
The problem about our society is that, people ‘find’ themselves pregnant, most pregnancies are never really planned. In this case then, you should start taking your folic acid tablets as soon as you find yourself pregnant and not wait till the pregnancy is advanced like the way most people do.

 PRESCRIPTION DRUGS
Drugs that cause birth defects are known as teratogenic drugs in the medical world.
Women who have chronic illnesses and are on drugs should first discuss with their doctors and have their drugs changed to safer ones before they get pregnant.
Pregnant women should also avoid buying drugs over the counter because they may not know if a particular drug is safe for their unborn children.

Some of the commonest teratogenic drugs include;
1. Drugs used in the treatment of epilepsy- carbamazepine{tegretol}, phenobarbitone and phenytoin[epilim].
2. Some drugs used to treat hypertension- eg enalarpril, lisinopril etc
3. Some antibiotics like amikacin, gentamycin, may cause deafness
4. Drugs used in the treatment of cancer, like thalidomide may result in phocomelia, a disorder where someone is born without limbs
5. Some ARVS like Dolutegravir-has a potential risk for spina bifida

 MATERNAL OBESITY
Having a body mass index (BMI) of more than thirty percent is associated with a risk of heart defects in your child.
Women intending to become pregnant should therefore try and lose weight before becoming pregnant to reduce the chances of getting a child with heart defects

 INFECTIONS
Pregnant women should be screened and treated for the following infections; toxoplasmosis, rubella, cytomegalovirus, herpes simplex,
All pregnant women should routinely be screened and if found to be infected, they should be treated.
If untreated, cytomegalovirus may cause anomalies such as hearing loss, vision loss or mental disability.
Toxoplasmosis may result hearing loss, or even visual impairment in a newborn.

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