community medicine and teaching methadology presentation.pptx
- 2. SPINA BIFIDA :
• Spina bifida is a birth defect that occurs when
the spine and spinal cord don’t form properly.
It is also called neural tube defect. The neural
tube is the precursor for the child’s brain and
spinal cord. In spina bifida a part of the neural
tube fails to develop and this leads to defects in
the spinal cord and spine.
• Around 1, 400 Babies are born with spina bifida in U. S every year .
- 3. TYPES :
SPINA BIFIDA OCCULTA :
It is a defect which result from
failure of formation of bony
arch around the spinal cord, but
spinal cord and meninges are
normal. It is not visible
externally.
SPINA BIFIDA CYCSTICA : It is a defect in
the closure of posterior vertebral arch with
protrusion of spinal cord and meninges through
the defect.
a) Meningocele: It is a sac like herniation
through the bony malformation, containing
meninges and cerebrospinal fluid.
b) Myelomenigocele: It is a sac like
protrusion of spinal cord, CSF and meninges
through spinal cleft. It is mostly found in
lumbar or lumbosacral region.
- 4. CAUSES :
• Folic acid deficiency .
• Diabetes.
• Obesity.
• Genetic factor.
• Some medicine like anti-seizure(valproic acid) .
• COMPLICATIONS :
Depends on the severity of the defect;
• Walking problems due to muscle weakness and sometimes paralysis.
• Orthopedic problems like scoliosis, dislocation of hip and contractures
due to muscle weakness.
• Bowel and bladder problems due to damage to concerned nerves.
• Hydrocephalus and chiari malformations are associated disorder.
- 5. DIAGNOSIS :
During pregnancy:
• Maternal serum alpha fetoprotein test: abnormally high level of
alpha fetoprotein in the serum suggests a likely hood of neural tube
defect.
• Abdominal ultrasound scan to see for features of neural tube
defects.
• Amniocentesis: drawing fluid from the sac around the baby in the
womb and to estimate the AFP levels. High levels suggest a neural
tube defect.
PREVENTION :
• Dietary supplements with folic acid has been shown to be helpful in reducing
the incidence of spina bifida. Sources of folic acid include whole grains,
fortified breakfast cereals, dried beans, leaf vegetables and fruits.
• It is recommended that any woman considering becoming pregnant take 0.4
mg of folic acid a day. Pregnant women need 1 mg per day
- 6. TREATMENT:
The mildest forms of spina bifida may need no treatment. The
main treatment for more serious types is surgery.
1. Fetal surgery. Doctors can operate on some babies while
they're still in the womb. Before the 26th week of pregnancy,
the surgeon may be able to sew shut the opening over the
baby's spinal cord.
2. Newborn surgery. Another option is surgery shortly after birth,
often in the first 24-48 hours. If the baby has meningocele, the
surgeon will put the membrane around the spinal cord back in
place and close the opening. If the baby has
myelomeningocele, the surgeon will put the tissue and spinal
cord back inside the baby's body and cover it with skin