WORLD HYDROCEPHALUS AND SPINA BIFIDA DAY 25TH OCTOBER
25th October 2022: Neural tube defects are the leading non infectious birth defects with a worldwide prevalence of 1-2 per 1000 live births. The prevalence in India has been reported to vary from 1-11 per 1000 live births. These are not community-based studies. They are all hospital based.
Spina bifida occurs during the third and fourth weeks of pregnancy when a portion of fetal spinal cord fails to close. This results in the child being born with a part of spinal cord exposed on the back. The risk of having a second affected child increases by 2-3% and its around 10% for the third child. Although genetic and environmental factors play a role around 95% of babies with spina bifida are born to parents with no family history. Women with diabetes and seizure disorders on medication have an increased risk of having a baby with spina bifida.
- OCCULTA: it’s a simplest form of the condition were there will be only a bony defect in the vertebrae that make up the spine. It occurs in around 12%. Most are unaware that they have this problem. Its discovered only when an Xray is done for an unrelated reason. Very rarely one can develop bladder or bowel dysfunction or low back pain with limb weakness.
- MENINGOCELE: occurs when the bones do not close around the spinal cord and the coverings of the cord are pushed out through the opening. The spinal cord and the nerves are normal. The swelling is covered by skin and needs surgery.
- MYELOMENINGOCELE: accounts for more than 75% of the cases. It’s the most severe form of the disease, in which a portion of the spinal cord protrudes through the bony defect. Some cases have skin cover, while nerves and spinal cord are exposed in the remaining. These unfortunate babies will have severe neurological disabilities and many might succumb.
HOW IS IT FOUND?
Maternal screening tests and ultra sound scan of the fetus. Maternal blood tests for alpha fetoprotein, 20 weeks ultrasound and fetal MRI are some of them.
Women in child bearing age can reduce the risk of having a baby with spina bifida by 70% if they take folic acid (vitamin B6) every day. Afterall prevention is always better.
by Dr. Sai Sudarsan, Sr. Consultant/Surgeon – Neuro Surgery | Pulse Hospital Ranchi
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