A child has Transposition of Great Aeries. The mother should be investigated for:
Correct Answer: diabetes mellitus
Description: Best test to predict risk of congenital malformation in ove diabetic females is estimation of HbA1C levels- <6.5%: no greater risk than non diabetic mothers ; 6.5-8.5%: risk of anomalies is 5% ; >10%: risk of anomalies is 22% . Best investigation to detect congenital anomalies in fetuses of diabetic mothers- Level II scan/TIFA (TARGETED IMAGING FOR FETAL ANOMALIES) done at 18-20 weeks - Now, The most common defect when we ask, we are asking for the purpose of Diabetes and its specific defects for the baby... not for anything else. The most common anatomical defects of babies born to mothers with Ove DM are cardiac: In cardiac defects, the most specific is TGA and thats a common defect too. Though we also see VSD and PDA. Now, No one will ask about VSD since VSD is seen in every other syndrome! also, sacral agenesis.... this is a rare defect, much lesser than cardiac defects. If this is seen in a newborn, we think of diabetes in the mother since this is a specific structural defect seen in Newborns of Ove Diabetic mothers. But as compared to Transposition of great vessels, this is much lesser common. So yes, if asked between TGV and Sacral agenesis, which is the more common Specific Defect, then its TGV for newborns born to mothers with ove diabetes.
Category:
Gynaecology & Obstetrics
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