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29 yr female presents 3 wk of pregnancy, her first child had congenital adrenal hyperplasia, she is concerned about her second child, especially if her next child is a girl, how would you manage this patient?

A. tell her she should not worry, we wil treat her after birth
B. treat her with Dexamthasone now
c. tell her we should get genotyping of fetal cells at 8-10 wks
d. treat her with dexmethson only after sex of the child is determined

A. tell her she should not worry, we wil treat her after birth

tell her she should not worry, we wil treat her after birth

genitalia start developing at 5-8 weeks, so treatment should be started now, with CVB done at 10 weeks, if fetus is male or unaffected female, treatment should be stopped. If fetus is female and affected treatment should be continued till term at which time definitive diagnosis should be made.