Spina Bifida Literature Review

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This article examines spina bifida, a neural tube defect, in children and describes relevant prenatal testing, prenatal surgery, ongoing care, and the prospects of prenatal surgery. When describing the factors associated with spina bifida, the article noted the role of genetics, gene mutations, hormones, and maternal nutrition which particularly includes “the enrichment of staple foods with folic acid” (Sikander et al., 2017). During pregnancy, an increase in folic acid has been found to correlate with a decrease in the incidence of spina bifida, as well as other neural tube defects. Prenatal tests used to diagnose spina bifida include a maternal serum alpha fetoprotein (AFP) screening, Doppler ultrasound, pedigree analysis, and fetal ultrasonography. The article states that generally a maternal blood test is done at 15-20 weeks gestation, and “the amount considered standard for that gestational period is compared to the amount of AFP in the mother’s blood” (Sikander, et al., 2017). If the AFP is high, another blood test is done and an ultrasound to confirm the presence of a neural tube defect. Sometimes an amniocentesis is also done when there are abnormally high AFP levels. …show more content…
In the case of spina bifida, the “pregnant mother’s uterus is opened surgically and surgeons repair the baby’s spinal cord in interuterine surgery, which is done before the 26th week of pregnancy” (Sikander et al., 2017). Surgery is preferred prenatally because nerve function in babies with spina bifida seem to get worse after birth. Ongoing care will include additional surgeries, as well as ongoing lifelong care from a team of surgeons, physicians, and therapists. Treatment for bladder and bowel problems associated with paralysis also begin shortly after
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