Low levels of the vitamin folic acid during pregnancy are linked to spina bifida. Folic acid plays a large role in cell growth and development, as well as tissue formation. Not having enough folic acid in the diet before and during early pregnancy can increase a woman's risk of spina bifida and other neural tube defects. The causes of spina bifida in pregnancies where mothers took prenatal vitamins and got enough folic acid are largely unknown.
Some evidence suggests that genes may play a role, but most babies born with spina bifida have no family history of the condition. A high fever during pregnancy may increase a woman's chances of having a baby with spina bifida. Women with epilepsy who have taken the drug valproic acid to control seizures also are at an increased risk of having a baby with spina bifida.
Expectant parents may be able to find out if a baby has spina bifida by taking certain prenatal tests. The alpha-fetoprotein AFP test is a blood test done between the 16th and 18th weeks of pregnancy. This test measures how much AFP, which the fetus produces, has passed in the mother's bloodstream. If the amount is high, a repeat test may be done to make sure that the result is correct. If the second result is high, it could mean that a baby has spina bifida.
In this case, other tests will be done to double-check and confirm the diagnosis. In most cases of spina bifida aperta, doctors can see the defect on a prenatal ultrasound.
Amniocentesis also can help determine whether a baby has spina bifida. A needle is inserted through the mother's belly and into the uterus to collect fluid that is tested for AFP. Usually, spina bifida occulta is not found until after a baby is born.
To diagnose the condition in these cases, doctors may do an ultrasound on younger babies less than 3 months old. For older babies, and to confirm results in younger babies, doctors may rely on a magnetic resonance imaging MRI scan or computed tomography CT scan. Treatment for spina bifida depends on its severity.
Because spina bifida can involve many different body systems, like the nervous and skeletal systems, children may need support from a team of medical professionals. This team may include doctors such as neurosurgeons, urologists, and orthopedic surgeons , physical and occupational therapists, and social workers. Babies with spina bifida occulta might not need any treatment, unless their spinal cord is tethered.
Tethering can lead to problems later in life during growth spurts so it's necessary to surgically detach the spinal cord from surrounding tissue. After surgery, babies usually have no long-term health problems, but may need surgery again later in childhood if the spinal cord reattaches.
Babies with a meningocele need surgery to push the meninges back into the body and close the hole in the vertebrae or skull. This is usually done in the first few months of life. Babies with a myelomeningocele need surgery 1 to 2 days after birth to protect the exposed area and central nervous system, and to prevent these areas from becoming infected.
If a myelomeningocele is detected early enough during a woman's pregnancy, the fetus can be operated on to correct the defect during the 25th week of pregnancy. Spina bifida can range from mild to severe. Some people may have little to no disability. Other people may be limited in the way they move or function. Some people may even be paralyzed or unable to walk or move parts of their body. Learn about living with spina bifida at different ages ».
Skip directly to site content Skip directly to page options Skip directly to A-Z link. Spina Bifida. Section Navigation. Facebook Twitter LinkedIn Syndicate. What is Spina Bifida? Minus Related Pages. On This Page. Links with this icon indicate that you are leaving the CDC website. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
You will be subject to the destination website's privacy policy when you follow the link. Babies with myelomeningocele and closed neural tube defects may have muscle weakness in their feet, hips, and legs that result in joint deformities first noticed at birth. Mild cases of spina bifida occulta, closed neural tube defects not diagnosed during prenatal testing may be detected postnatally using ultrasound or X-ray imaging to look at the spine.
Doctors may use magnetic resonance imaging MRI or a computed tomography CT scan to get a clearer view of the spinal cord and vertebrae. To evaluate for hydrocephalus , the doctor will request a head ultrasound, CT or MRI to look for extra cerebrospinal fluid inside the brain. Treatment depends on the type of spina bifida a person has. Myelomeningocele and meningocele require a surgery to close the bubble shortly after birth to prevent infection such as meningitis.
Most people with myelomeningocele have hydrocephalus and most of them will need a shunt placed as an infant. Children with a closed neural tube defect may need surgery to prevent further complications such as weakness and bowel and bladder function. Generally, people with spina bifida occulta will not need any treatment.
The Management of Myelomeningocele Study MOMS showed that prenatal surgery to close the defect in the spinal cord improved outcomes compared to children who had postnatal surgery for spina bifida.
Data from the study showed that prenatal surgery reduced the need to drain fluid from the brain, improved mobility, and increased the chances that a child will be able to walk independently early on. The procedure does not restore lost neurological function that happened before the surgery, but may prevent additional damage from occurring during the rest of the pregnancy.
Although prenatal surgery poses some risk to the fetus as well as to the mother, the benefits are promising and are still being studied. In treating myelomeningocele and meningocele, the key priorities are to prevent infection from developing in the exposed nerves and spinal cord through the spinal defect, and to protect the exposed nerves and spinal cord from additional trauma.
Therefore, a child born with these types of spina bifida who has not undergone prenatal surgery will have surgery to close the defect and minimize the risk of infection or further trauma within the first few days of life. Some children with myelomeningocele and closed neural tube defects will need surgery to improve the alignment of their feet, legs, or spine. Children with myelomeningocele usually have hydrocephalus and may require surgery to help drain fluid in the brain, such as the placement of a shunt or ETV.
Multiple surgeries may be required to replace the shunt, which may become clogged, infected, or disconnected. Some individuals with myelomeningocele or closed neural tube defects require assistive devices for mobility such as braces, walkers, crutches, or wheelchairs.
The location of the defect on the spine often determines the type of assistive devices needed. Children with a defect high on the spine will have little movement of the legs and will use a wheelchair for mobility. Children with a defect lower on the spine usually have more strength in the legs.
They may be able to walk independently, or they may use crutches, leg braces, walkers, and wheelchairs depending on the activity. Children with myelomeningocele usually have some degree of delayed mobility, so they are referred to physical therapists early on to maximize their strength and function. Treatment for bladder and bowel dysfunction typically begins soon after birth. Children with myelomeningocele and some closed neural tube defects have damage to the lowest spinal nerves which control typical bowel and bladder function.
Some children may be able to urinate typically, but most will need to drain their bladders with a catheter or thin tube times a day to remain dry in between and to prevent kidney damage. Kidneys are monitored closely so that medications or surgeries can be performed to prevent renal failure.
To prevent bowel accidents many people with myelomeningocele and closed neural type defects will use rectal medications or large volume enemas to have planned bowel movements. Close follow-up with a spina bifida specialty clinic is recommended to develop a safe bowel and bladder program.
0コメント