Fetal spina bifida
Spina bifida, also known as myelomeningocele, is a congenital defect that
affects the development of the back bones, spinal cord, surrounding nerves, and
the fluid-filled sac that surrounds the spinal cord. This neurological condition
can cause a portion of the spinal cord and the surrounding structures to develop
outside the body. The sac-like lesion can occur anywhere along the spine. Many
of the infants born with spina bifida may also have hydrocephalus, in which
increasing pressure inside the head causes the skull bones to expand.
Spina bifida is a relatively common birth defect occurring
in approximately 1 in 2,000 live
births. It is found five times more often in females than males.
More here on the
physical effects of spina bifida.
Prevention
Studies have shown that folic acid (vitamin B-12) consumption prior to and
soon after conception can help prevent spina bifida in some cases. It is
recommended that women take a multivitamin containing folic acid for one to two
months prior to conception and throughout their first trimester.
Diagnosis
Fetal spina bifida can be diagnosed by ultrasound
examination prior to birth between 18 to 22 weeks of pregnancy. This diagnosis
is made in conjunction with a blood test to confirm what is found on the
ultrasound. Fetal magnetic resonance imaging (MRI) may be performed to provide
additional information regarding the anatomy of the spine and brain. More here on fetal MRI.
Treatment
After fetal spinal bifida is diagnosed, the staff in the divisions of
orthopaedic surgery and neurosurgery at Children's Memorial counsels the parents
and prepares them for what to expect when their baby is born. Plans are made to assure that the baby
is delivered in a hospital that has a neonatal intensive care unit (NICU) with a
neonatologist present at the delivery.
Often times a cesarean delivery is necessary to avoid damaging the baby's
spinal cord.
Research is still being done to determine if performing surgery on the
fetus in utero is beneficial to the infant after he is born. Researchers hypothesize that early
repair may prevent hydrocephalus; however, any surgery performed in utero has
additional risks. It is anticipated
that the results of these studies will determine if fetal intervention can
improve the long-term outlook for children with spina bifida.
More here on our multidisciplinary program.