Neural tube defects are birth defects involving the brain and spinal cord. The neural tube develops in the first four weeks of fetal development, often before a woman realizes she is pregnant. The neural tube grows into the central nervous system, which includes the brain and the spine. The exact cause for neural tube defects is not completely understood, but studies have shown that taking adequate amounts of folic acid before pregnancy decreases the likelihood of neural tube defects. In many cases, an elevated second trimester maternal serum alpha-fetoprotein is discovered which may indicate the defect. Diagnosis is usually made during a prenatal ultrasound by the obstetrician.
One of the most common neural tube defects is spina bifida.Often referred to as open spine, spina bifida means the neural tube did not properly close, which can cause damage to the spinal cord. There are three types of spina bifida.
- Myelomeningocele is the most common and severe form of spina bifida. At the open part of the spine there is a sac consisting of spinal cord and nerves. The sac may be broken or intact at delivery. The function of the nerves, muscle movement and sensation cannot be restored, resulting in paralysis, bowel and bladder control problems. Surgical repair of myelomeningocele usually occurs between 24–48 hours after delivery. A helpful Web site is Spina Bifida Association.
- Meningocele is a fluid filled sac at the open part of the spine. Spinal nerves are not involved. Surgery is performed to remove the sac, and normal development usually occurs.
- Occulta usually does not require treatment, and the spinal cord nerves are usually normal. This is the mildest form of spina bifida. It cannot usually be seen on prenatal ultrasound, so it is not diagnosed until after birth.
Anencephaly is the most serious type of neural tube defect in which most of the brain never develops. Babies die shortly after birth or are stillborn.
The Myelomeningocele Team at Nationwide Children’s Hospital
This team is a group of dedicated professionals who manage the care and treatment of children with spina bifida. The team members include: Neurosurgeon, Developmental Pediatrician, Clinical Nurse Specialist, Nurse Coordinator, Social Worker, Orthopedic Surgeon, Urologist, Physiatrist (rehabilitation specialist) and Ophthalmologist.
- MOMS Trial
A study to find out if prenatal surgery will improve the outcome of babies with spina bifida is being done at three sites in the USA. To learn more about the MOMS (Management of Myelomeningocele Study), click on this link. http://www.spinabifidamoms.com/english/index.html