A couple of weeks ago, a young lady walked into my consulting room. She had missed her period. You’re probably wondering why this is a big deal, yes? I urge you to read on.
Usually, the first thing that is expected of a lady shortly after she misses her period is to run a pregnancy test. This can be done with the aid of the home kit, which is available over-the-counter; alternatively, she could have it done at any good hospital or diagnostic centre nearby.
Once pregnancy has been confirmed via the pregnancy test, the next step is to see your gynaecologist, who will schedule you for your first ultrasound scan as soon as possible, ideally at about 2 to 3 weeks after you had missed your period. This is done to confirm the location and the viability of the pregnancy. Afterwards, you will be advised to commence antenatal care, when your pregnancy has reached 3 months (or 13 weeks since the first day of your last menstrual cycle).
Now, let’s take it back to the beginning of the article. This lady missed her period, and like most women would normally do, she ran a pregnancy test which came out positive. It was at this point things got a bit interesting. First of all, for reasons best known to her, she refused to have an ultrasound scan done. She chose to wait till she was, not 3, but 5 months gone (yes, FIVE, as in The Jackson Five, Five Alive, the Famous Five, you get my point).
At this point, things get a little more interesting. Before I asked her to have an ultrasound scan done, I asked a number of questions; the most important ones being :
Why did you wait this long before coming to the hospital for a scan?
Hope you have already started taking your Pregnancy Medication?
Her answer to the first wasn’t definitive. She just did not feel the need to “rush”, since this wasn’t her first pregnancy. Her response to the second question, sadly, was no. She had not taken any pregnancy meds at all, not even folic acid. At this point, I wasn’t comfortable with the circumstances. I went on to enlighten her of the dangers of not having a scan done early enough, and the negative effects of not taking folic acid early enough. Her response was the typical Nigerian Woman Response; “Doctor, it is not my portion”.
It was time for the ultrasound scan, and I got to conduct the scan myself. The first touch of the ultrasound scan transducer on her abdomen led to a shocking revelation (more of a confirmation of my suspicion for me). The baby had no head.... Okay, that’s a bit of an exaggeration. The baby had a head, but the part of the skull that covers the brain was completely missing, together with most parts of the brain. This condition is called ANENCEPHALY, a word derived from 2 Greek words, which are loosely translated to “No Head” (hence my initial exaggeration).
This was a “Told you so” moment, but not one I was particularly thrilled about. The implications were devastating for the lady. Here’s why. When a baby is born with the cranium and most of the brain absent, it basically is unable to carry out basic functions, like swallowing and breathing. It goes without saying, this medical condition is not compatible with life. As at the last time I checked, only about 3 or 4 babies born with this condition lived after birth, and of these ones, none made it past 1 year. Did I mention that they were all on life support throughout this period?
This lady was faced with the painful decision of terminating a 5 month old pregnancy; because of a condition that could have either been detected early or even prevented altogether.
So, ladies, here are the important lessons to take home from this:
The moment you miss your period and confirm pregnancy with a blood pregnancy test, start taking folic acid. In fact, it is now advisable that every woman who is trying to get pregnant should be on folic acid daily, because folic acid is important for the early development of the embryo, especially the skull and the spine. These structures start to form very early in pregnancy, long before you realise you are pregnant, so you need to already be on folic acid to ensure that you don’t miss this crucial phase.
It is never too early to do an ultrasound scan. Two weeks after you have missed your period is the ideal time for your very first scan. A scan at this stage is done to check the location and the viability of the baby (the baby could be outside the womb). A repeat scan when the pregnancy gets to 3 months helps confirm that all is well.
We’ll stop at this point. Hope you all learned a thing or three. If you have questions or comments, feel free to connect with me on social media; @VirtualClinicNG on twitter and instagram, send me a mail to firstname.lastname@example.org , or reach me on whatsapp : 08186188299. Subscribe to my Blackberry channel (pin :C004D9D17), and add me up on Blackberry Messenger , pin: 534592B5. Till next time, it’s Dr Andre, signing out. Cheers.