Spina Bifida

spina bifida fetus

Last Updated December 20th, 2021

Overview of Spina Bifida

Birth defects are on a steady rise due to the increasing burden of environmental and associated factors. Among the several reported cases of congenital defects, neural tube defects are common. At present they are affecting millions of children all over the world. People having a familial history of these disorders are 5-10 times more likely to develop neural tube defects than the rest. Spina bifida is one such neural tube defect that affects the spine.

Nearly 5% of the newborns suffer from a particular variant of spina bifida known as spina bifida occulta. With the major technological advancement in the medical field, the occurrence of these diseases can be detected in the pregnancy period itself. Therefore, matters like the continuation of the pregnancy and the associated risks should be consulted with a doctor.

 

What is spina bifida?

spina bifida fetusSpina bifida is a type of neural tube defect characterized by incomplete closure of the backbone and the membrane surrounding the spinal cord. In non-medical terms, it means “split spine”. A gap or split in the spine is observed in this case. This arises from a poorly formed spinal cord and vertebral bones. It usually occurs during the first four weeks of pregnancy. It is a congenital disorder.

The newborns with spina bifida generally have lesion(s) on their spinal cord. These lesions are the sites of damage to the spinal cord and the associated nerves. Numerous complications may stem from this disease. The most important one is paralysis of the lower limbs which depends on the exact location and severity of the lesion. In certain cases, no prominent lesion is observed. But the child may be born with a missing vertebra and may have severe nerve damage.

 

What causes spina bifida?

The exact etiology of spina bifida is still not established. Several research studies in the recent years have proposed certain theories that may explain the complications. It is typically regarded by some neurologists as a multifactorial birth defect. This implies that the disease is attributed to multiple factors like genetic, environmental and dietary factors.

Recent studies have shown that the paucity of folic acid (Vitamin B9) in the diet of pregnant women can increase the risks of the disease. It is therefore advisable that the women of childbearing age should consume 0.4 mg of folic acid daily, or at least 3 months before pregnancy. Women with a history of childbirth with neural tube defect should consume 4.0 mg of folic acid every day before her next pregnancy.

Alcohol consumption increases the risks of macrocytosis, which discard the metabolism of folate in the body. This may eventually lead to neural tube defects. Even after the cessation of alcohol consumption, these women should allow enough time for the formation of healthy bone marrow. Studies have shown a demographic variation of the disease. Hispanics, particularly the Hispanic girls are more susceptible to the disease.

 

What are the main signs and symptoms?

Spina bifida appearenceThe main physical manifestations include-

  • Weakness of limbs
  • Paralysis
  • Orthopedic problems- scoliosis, clubfoot, hip dislocation
  • Urinary incontinence- Kidney dysfunctions, urinary tract infection, lack of bladder control
  • Bowel incontinence
  • Skin irritations and rashes
  • Pressure sores (ulcers)
  • Abnormal eye movements
  • Allergy to latex

Babies born with spina bifida have structural abnormalities of the cerebellum. Diagnoses reveal that the posterior portion of the brain is pushed from the back of the skull into the lower neck. The displaced cerebellum often interferes with the normal flow of the cerebrospinal fluid (CSF). In 70-90% of the patients, the corpus callosum is malformed. This leads to a disrupted coordination between the left and the right brain lobes.

The following neurological abnormalities are observed-

  • Executive function: The affected children may face difficulties in planning, organizing and initiating an activity. They may also have a poor working memory and cognitive deficits. Some of these children may also have ADHD.
  • Academic skills: The children may lack mathematical skills, which are mainly associated with the parietal lobe.

 

What are the different types of spina bifida?

Spina Bifida ribbonSpina bifida has three subtypes.

  • Spina bifida occulta: Nearly 15% of the affected people have this form but exhibit no symptoms. Hence it is also called “hidden spina bifida”. In this condition, the spinal cord and the surrounding structures remain inside the body. However, the backbones in the lower back region are poorly formed. A hairy patch or a slight dimple may be present at the site of the defect.
  • Meningocele: It is a moderate form of spina bifida characterized by the presence of a fluid-filled sac outside the back. The sac does not contain the spinal cord or the nerves.
  • Myelomeningocele: It is the most severe form of spina bifida where the spinal cord and the nerves develop outside the body. They mostly remain inside a fluid-filled sac that forms on the back. These children generally have a loss of sensation below the defect. Many of these babies have an accumulation of fluid inside their heads, a condition termed as “hydrocephalus”. It exerts immense pressure on the skull bones that eventually expand to an abnormally large size.

 

How can the disease be diagnosed?

The diagnosis of spina bifida can be done in the gestational period or after childbirth. Both the cases are discussed below-

  • Prenatal diagnosis: The common screen test is the measurement of Maternal Serum Alpha-Fetoprotein (MSAFP).
  • Postnatal diagnosis: X-ray, CT scan, and MRI scan can reveal abnormalities in the spinal cord and the skull.

 

Is it possible to treat spina bifida?

The treatment mainly involves surgery (prenatal or postnatal). Prenatal surgeries are performed by surgically exposing mother’s uterus before the 26th week of pregnancy. Fetal surgeries reduce the extent of disability the child might have after birth. Cesarean birth is sometimes a safer way to deliver in case the fetus has myelomeningocele.

Treatment is also required for the complications arising due to spina bifida. Walking and mobility aids such as crutches, braces, walkers, wheelchairs etc. can help the child to walk and move around. Children facing difficulties in bowel management can be given oral medications, suppositories, and enemas. Surgical intervention or a combination of two or more methods can be opted based on the condition. Bladder management is done by the use of medications or catheters.

Though the exact reason behind the neural tube defect is unknown, prevention of spina bifida is possible to a certain extent by focussing on the diet and overall health of the expecting mother. A balanced diet rich in folate and other nutrients is essential.

 

Dos and Don'ts

Dos
  • As folate deficiency can possibly cause spina bifida, pregnant females and females trying to conceive should take optimum levels of vitamin B supplements. Include veggies (such as beans, broccoli, and spinach) and citrus fruits in the diet.
  • Diabetic females should keep an eye on their blood sugar levels. Uncontrolled levels of blood sugar during pregnancy can lead to spina bifida.
  • Maintain a healthy body weight before and during pregnancy. Pre-pregnancy obesity is linked to the increased risk of spina bifida.
Don'ts
  • Take certain medications which interfere with the body’s ability to use folate and folic acid. Females taking anti-seizure medications such as valproic acid should consult a registered physician before planning to conceive.
  • Indulge in smoking and consumption of alcohol during pregnancy as it might lead to neural tube defects in the child.
  • Use saunas and hot tubs during the early months of pregnancy. An increase in the core body temperature can increase the risk of spina bifida and other neural tube defects.

 

 

 

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Propolis: Yet another amazing gift by the bees to the humans Bee propolis is yet another generous gift by the bees bestowed on the human race. They utilize substances…
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
liver biopsy procedure
Liver Biopsy Liver biopsy or hepatic biopsy is a diagnostic tool that collects a sample of live tissue from the…
GERD heartburn
Heartburn: What are the exact symptoms and the best home remedies? There are easy home remedies for heartburn, which not only acts as a first aid when you experience…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
liver detox facts
7 liver detox facts and why ignoring these could kill you! Are you taking care of this organ that handles over 500 different vital functions in your body? Your…
Astaxanthin: Why experts believe it could be 550x more potent than vitamin E! What is astaxanthin and why is this new supplement on the block touted as the most powerful antioxidant…
Milk Thistle skin
Milk Thistle: Find possible cures for fatal diseases in these purple blooms Milk thistle is well-known for treating liver conditions. However, did you know that it comes with a plethora…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
kidney stones
Kidney stones Kidney stones are solid substances made up of crystals. They can be of various sizes. Treatment depend on…
free psa test
Free PSA Test The free PSA test is used to detect the level or percentage of free PSA in the body…
Experts reveal the safest ways to perform an enema at home The idea of pushing some up your rectal area might make you queasy but an enema could actually…
Urologist: When should you visit one and why? A urologist can treat not only genitourinary problems of both men and women but also can treat various…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
6 arguments in favour of glucosamine and where can you find it Studies have shown that glucosamine works by preventing the breakdown of cartilage of the joints. This is usually…
Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
Miracle extract from the root of maca: 10 ways it can help you! Maca root has been used for years in herbal medicine. Today scientific research is unearthing fresh evidence in…
lipase test
Lipase Test A lipase test is a blood test performed to quantitatively measure the level of the enzyme lipase in…
Diabetes blood test
Diabetic Profile The diabetic profile is a set of tests used for testing and monitoring the various kinds of Diabetes…
Lauric Acid: 8 health benefits you can derive from coconuts Appropriate use of saturated fats containing lauric acid can provide you numerous health benefits. This is the main…
kshar sutra
Kshar sutra treatment for piles, fissures and fistula Read to know the benefits and side effects of kshar sutra to treat anal piles, fissures, and fistula…
superfoods quinoa probiotics
10 fantastic Superfoods you need to include in your diet from today! What exactly are superfoods and how do they battle diseases? From losing weight to looking ravishing- these superfoods…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
creatinine
Creatinine Test The level of creatinine in the blood is a significant indicator of the health of your kidneys. This…
Piaget stages: Do they accurately describe the way the human brain develops?  A common assumption was that children are less competent thinkers as compared to adults, but this was refuted…
Pelvic_ultrasound
Pelvic Ultrasound Pelvic ultrasound is a process where sound waves are used to create image of your pelvic region organs…

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