Introduction
Spina bifida, or myelomeningocele is a type of open neural tube defect that can occur with problems with the early development of a fetus. Doctors believe that both genetic and environmental factors play a role. During the first 28 days of a pregnancy, the brain and spinal cord form in the developing fetus. Spina bifida results when the tissue at the bottom of the spinal cord fails to close at the bottom end. The majority of babies with spina bifida have a variety of medical problems including nerve damage and problems with motor function, including some amount of paralysis of the lower part of their body (this ranges from very mild to quite severe), loss of control of their bowels and bladder, and abnormalities of the brain.
Historically, spina bifida was detected through maternal serum screening of elevated alpha-fetoprotein at 16 to 18 weeks of gestation, followed by amniocentesis. A better option is the assessment of Acetyl choline Esterase form amniotic fluid.Today, detection rate is 98% at the time of an anatomical screen ultrasound at 16 to 20 weeks of gestation.
For decades the standard treatment has been to close the spinal defect soon after the baby is born. This is called postnatal surgery. Recently, doctors have developed an experimental operation performed while the baby is still in the mother’s womb. This is called prenatal surgery. Prenatal surgery may improve the outcome of babies born with spina bifida.
Read more about this topic: MOMS Trial
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