A pregnant mother presents with history of delivery of a previous child with Congenital Adrenal Hyperplasia (CAH). The best management protocol for the current pregnancy is:
CAH is autosomal recessive; if a woman has previously had a child with CAH and again becomes pregnant the same paner, her fetus will have a one in four chances of having CAH. Because the period during which the genitalia of a female fetus may become virilized begins only 6 wk after conception, treatment must be instituted essentially as soon as the woman knows she is pregnant. Ref: Novak's Gynecology 14th edition, Page 1095 ; Medical care of pregnant patient (American college of physicians) 2nd edition, page 298, 299
To sta prednisolone after establishing whether fetus is affected by Chorionic Villous Sampling
To sta dexamethasone as soon as pregnancy is confirmed
To sta dexamethasone after determining sex of the fetus by Karyotyping
To sta prednisolone after determining sex of the fetus with USG