Spina Bifida

Spina bifida is the one of the most common birth defects in the United States, affecting one in every two thousand live births.

Also called a cleft spine, spina bifida is a birth defect that affects the backbone and spinal cord. It is the most common neural tube defect (NTD). A neural tube is the embryonic structure that develops into the brain and spinal cord.

Causes of Spina Bifida
Up to 95% of spina bifida cases are isolated birth defects, meaning that the majority of cases do not have a genetic link. In the majority of cases the cause of the defect is unknown, however, babies whose mothers had fevers during pregnancy have a greater chance of being born with spina bifida.

Women who have taken valproic acid to decrease the frequency of seizures caused by epilepsy are also more likely to give birth to babies with spina bifida, as are women with diabetes. Folic acid deficiency can also lead to neural tube defects.

How It�s Detected
Prenatal tests can be conducted to detect birth defects. A maternal serum alpha-fetoprotein (AFP) test is taken between 16 and 18 weeks; the level of AFP in the mother's blood is tested and if high levels of it are found in two subsequent tests, a diagnosis can be confirmed. An ultrasound, or amniocentesis (in which a needle inserted in the uterus collects fluid and tests for AFP) can also be used to detect the disease.

Detecting the disease as early as possible is crucial because it allows doctors to provide support and information to pregnant women. Future surgeries can also be planned before the birth.

Types of Spina Bifida
There are three types of Spina Bifida, ranging from mild to severe:

  1. Spina Bifida Occulta: Characterized as an opening in one, or more, vertebrae of the spinal column. There is no evident damage to the spinal cord. Most children born with this form of Spina Bifida don�t have health problems.
  2. Meningocele: The spinal cord is intact, but the meninges (sac), which protects it, is pushed out through the opening in the vertebrae. The meninges can be replaced with minimal damage to the spinal cord.
  3. Myelomeningocele: The most extreme form of spina bifida, in which a section of the spinal cord protrudes through the back. Seventy to ninety per cent of babies born with myelomeningocele have hydrocephalus, a large amount of fluid on the brain. This condition requires surgery, where a shunt is inserted to drain fluid. Learning problems are particularly frequent as a result of this type of spina bifida, as are problems with mobility and paralysis.


Quality of Life and Survival Rate
There are many physical and social problems associated with spina bifida. Paralysis is common in extreme manifestations of the disease. Depression is another symptom, as are learning disabilities (particularly with reading and math).

Attention deficit hyperactivity disorders (ADHD) are also common, as are bladder and bowel control problems.

In the past, babies born with spina bifida died shortly after birth. Today, early surgery is usually recommended and is often performed within the first forty-eight hours of birth. Surgery increases the survival rate, and many spina bifida patients live well into adulthood, however, children with spina bifida typically require several operations during their childhood to correct defects, particularly in the hips, feet and spine.

Women should ensure they get enough folic acid while pregnant in order to prevent spina bifida. A daily dose of 0.4 milligrams of folic acid is recommended and should be taken for at least three month before getting pregnant and throughout the first trimester.

Folic acid is found in foods such as eggs, dark leafy vegetables and orange juice. Multivitamins can also be used to ensure that the recommended daily dose is reached. Taking the proper amount of folic acid while pregnant can prevent up to 70% of neural tube defects, including spina bifida.

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