Grand Rounds Thanks to Inside Surgery

Many thanks to the team at Inside Surgery for including my first (of three) posts related to the possible association of abnormalities in folate metabolism and methylation with risk for Down syndrome in Grand Rounds 3.37. My series on this subject was prompted by a patient who had that combination of problems. She had a history of recurrent early pregnancy loss, was found to be homozygous for the C677T methylenetetrahydofolate reductase polymorphism, and finally (after being placed on 'therapy') carried a baby that unexpectedly had Down syndrome (trisomy 21).