Spina Bifida, or Myelomeningocele
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Spina Bifida is a congenital condition often referred to as a neural tube defect that occurs when the spinal cord does not develop properly. In its most severe form, myelomeningocele (MMC), the nerves are exposed to amniotic fluid and movement within the uterus, due to an opening in the child’s back. This exposure causes progressive neurologic injury to the unborn child and can be permanently disabling. The cause of spina bifida is currently unknown, and it occurs in about 1 in 2,000 live births. More commonly known environmental risk factors have been identified that contribute to neural tube defects, including lack of folic acid supplementation and low dietary intake of folate. However, lack of folate accounts for less than a third of all neural tube defects, suggesting a yet-to-be-identified genetic link to the disorder that prenatal vitamins alone cannot correct.
Screening and Diagnosis
Spina bifida is often detected around the 20th week of pregnancy during routine ultrasound scans and testing.
Treatment/Prognosis
Postnatal surgery within the first few days after birth has demonstrated some effectiveness, but doctors have discovered that performing revolutionary surgery to repair the baby’s defect before birth, while still in the mother’s womb, leads to better outcomes for the child. Soon after birth, the complications of spina bifida can be treated with mobility aids, bladder and bowel management, and surgery for hydrocephalus which allows fluid in the brain to drain, among other treatment options. Children with spina bifida may need ongoing care to monitor their physical and neurological health.
Medical advances are continually improving treatment options and outcomes so consulting with specialists and major children’s hospitals may be beneficial to find the best possible care.
Sources:
https://www.chop.edu/conditions-diseases/spina-bifida
https://women.texaschildrens.org/program/texas-childrens-fetal-center/conditions-we-treat/spina-bifida-myelomeningocele
https://www.cincinnatichildrens.org/service/f/fetal-care/conditions/myelomeningocele-repair
Spina bifida - Diagnosis and treatment - Mayo Clinic
Spina Bifida Life Expectancy - HRF (healthresearchfunding.org
Malloy C, Wubbenhorst MC, Lee TS. The perinatal revolution. Issues Law Med. 2019 Spring;34(1):15-41. PMID: 31179670.