A pregnant female presents with history of delivery of a previous child with congenital adrenal hyperplasia which will be best the best management protocol for current pregnancy ?
A. Start dexamethasone as soon as pregnancy confirmed
B.start dexamethasone after determining sex of the fetus by karyotyping
Start dexa and then at 10 weeks, do CVS to determine sex, and if female and affected, continue with dexa.
If male/female unaffected… switch to Hydrocortisone
Previously dexa used to start as soon pregnancy confirmed but it gives unnecessary exposure to male child, so buy now it is given only after confirmation… faculty will tell more precisely