Tuesday, February 20, 2018

title pic Spina Bifida: A Primer… and Some Hope

Posted by Claudia Grazioso on July 4, 2011

SpinaB: A PRimer And Some Hope

Though the phrase “spina bifida” often strikes fear into the hearts of expectant moms, it’s important to know that new surgical techniques are being developed and tested with some promising results as a way to treat this congenital birth defect.

But first, what is spina bifida? This congenital defect starts very early in pregnancy. In the beginning of the first trimester, cells on the baby’s back come together to form a neural tube. Simply put, spina bifida is when some of the vertebrae in the baby’s back do not fully fuse around the spinal cord, leaving it somewhat exposed.

There are several forms of spina bifida, including spina bifida occulta, which is the most mild form, and spina bifida cyctica, also called myelomeningocele, which is the most common form. In spina bifida occulta, the defect can be so mild that it goes undetected. Many people remain asymptomatic, but some new studies suggest that in people who suffer from back problems, the presence of spina bifida occulta might result in more severe levels of pain.

Myelomeningocele is the most common form of spina bifida, and unfortunately it is more serious. In most cases, it results in some kind of disability, the most common of which is paralysis. The paralysis occurs below where the defect in the spinal column is, so the higher up on the spine that the defect is, the greater the loss of mobility. Compounding this is that about 90 percent of people born with myelomeningocele will also have some degree of hydrocephalus, which can be serious and lead to brain damage and neurological impairments.

Though the causes of spina bifida are not fully understood, it appears that folic acid is a strong preventive medicine. Women with low levels of this B-vitamin in their blood are at greater risk for delivering a baby with spina bifida or other forms of neural tube defect. Some experts recommend that women who are considering becoming pregnant should take at least 400 micrograms of folic acid a day and pregnant women should take 1 mg daily. These doses are, of course, mainly guidelines and opinions. Talk to your doctor to determine how much additional folic acid you should take.

Aside from low levels of folic acid, other risk factors for spina bifida are diabetes or obesity in the mother, and a family history of babies with neural tube defects or spina bifida. Additionally, neural tube defects and spina bifida have been linked to some anti-seizure medications and anti-depressants taken during pregnancy.

What can be done? Surgery can be performed to close the opening and prevent any further damage — but it usually does not repair damage already done. However, there is reason to be hopeful. Intrauterine surgery on the fetus has been performed in trials and the results seem positive so far. In an article in the New England Journal of Medicine, doctors report that the results were beneficial enough to warrant the risk to the mother. Doctors even found that when they performed this surgery in utero, they could even lessen the severity of neurological damage. A less invasive surgical method is also being tested in Germany. So yes, there is hope even with a diagnosis of spina bifida. But as with everything else, you need to inform yourself.

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