Is it possible to detect neural tube defect earlier in pregnancy?

Question

Hello doctor,

We had a very first female baby with spina bifida. My wife started taking Folvite only after five days of missed periods. So we terminated the pregnancy during the fifth month in February 2022. As per the doctor's advice, my wife took MCBM69 (Folic acid 5 mg, Methylcobalamin 500 mcg, and Pyridoxine 10 mg) tablets for the past two and a half months and continues to take the tablet to date. My wife missed periods on the 28th day of the cycle this time, and we checked and found UPT to be positive. Our query is we already took Folic acid tables from last pregnancy and are continuing to date. Shall we proceed with this pregnancy as we have a history of neural tube defects? Is it possible to identify a neural tube defect in the NT scan earlier than before?

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concerns after having a previous baby with spina bifida. If she had taken a Folic acid supplement, the levels now would be normal. The reports' levels depend on the lab, and they would have given you a reference range for that lab. You can rule out neural tube defects (NTDs) from the first dating scan, which can be done at the sixth to eighth weeks, then the nuchal (NT) scan can be done. You can also do the alpha-fetoprotein (AFP) levels at sixteen weeks, double marker before NT scan.

All these will be screening methods for ruling out NTDs. It would help if you continued the pregnancy unless these tests showed anything abnormal.

Answer 2

Hi,

Welcome back to icliniq.com.

Double marker is for other anomalies like Down's syndrome and not neural tube defects (NTDs). NTD can be seen only on ultrasound and by doing the blood test alpha fetoprotein test (AFP).