Spina Bifida

Spina Bifida

What is Spina Bifida?

Spina Bifida is the medical name given to a birth defect in which the spinal column fails to form properly while the baby is developing in the womb. It is one of the most common the so called neural tube defects.

What causes it?

The entire spinal column in a healthy person is made up of a series of bones or vertebra which are stacked on top of each other. In the centre of each bone there is an opening through which the spinal cord runs. This opening creates a channel that runs the entire lenght of the spine and this channel is called the spinal canal.

Spina Bifida occurs when the rear part of the spinal canal fails to develop properly. This failure to develop leaves an opening in the spinal column leading to exposure of the nerve tissue within the spinal canal.. While Spina Bifida most often occurs in the lower back, it can actually affect any part of the spinal column.

The shaded area outlines the area of the

vertebra that fails to develop properly

What are the symptoms?

As part of the routine examination of a newborn baby, the spinal column is examined closely to see if there are any abnormalities. Depending on the form, location and severity of Spina Bifida, different symptoms may be present. The most common, and least severe, form of Spina Bifida is Occulta, where there is a very small opening in the spinal column and the spinal cord and protective membrane are not exposed to the surface. Many people with Spina Bifida Occulta are not even aware that they have the condition and are completely symptom free. Sometimes babies with this condition may have a small wisp of hair, a dimple, or a soft protrusion of skin over the area of the defect.

Meningocele is a more serious form of Spina Bifida, and this is easily detected as there is an obvious opening on the back. The protective membrane around the spinal cord may protrude through the opening, although the spinal cord itself and the nerves usually remain in place.

The third form of Spina Bifida is called Myelomeningocele and it is, by far, the most severe form of the condition. Babies born with Myelomeningocele will have a large opening in the spinal column which may, or may not be covered by a swelling of skin.. The protective membrane surrounding the spinal cord, along with the spinal cord itself and some nerves may protrude through the opening.

How is it diagnosed?

If the expectant mother undergoes amniocentesis, it is possible to detect birth defects such as Spina Bifida. Amniocentesis, which is now available at a small number of maternity hospitals in Ireland, involves inserting a fine needle into the womb through the abdomen and taking a sample of the amniotic fluid which surrounds the baby. This is then sent for laboratory analysis to detect any abnormalities.

It may also be possible to detect severe cases of Spina Bifida using ultrasonic x-ray techniques alone, and this diagnosis may be backed up by taking blood tests from the expectant mother at around the 5th month of pregnancy.

Is there any treatment?

As with any birth defect, treatment depends entirely on the severity and location of the defect. Mild forms of Spina Bifida do not require treatment, while severe defects may require surgery immediately after birth and on-going medical treatment for the remainder of the child's life.

It is important to note that surgery cannot correct any damage to the central nervous system. Unfortunately, this damage is permanent and the only function of surgery in this instance is to cover the defects so that infection can be prevented. I

What are the risk factors?

It is thought that Spina Bifida is caused by both genes and the environment. It is more common among babies born to women of European origin, and other risk factors include:

  • a history of Spina Bifida in the family
  • poor nutrition and, in particular, a lack of folic acid in the mother's diet at the time of conception.
  • taking certain medications during pregnancy, especially those used to control seizures and fits.

What are the long-term prospects?

As stated earlier, the long-term prospects for babies born with Spina Bifida are entirely dependent on the severity and location of the defect. In cases where there is severe damage to the central nervous system the baby may be significantly disabled.

There is always the risk of infection entering the body through the opening in the spine. Sometimes this can have serious consequences for the child.

The birth of a baby with Spina Bifida can have a traumatic effect on all those involved in the care of that infant, but most particularly on the parents and other close family members.

Can it be prevented?

Research has shown that folic acid has an important role to play in reducing the risk of birth defects and, in particular, the risk of developing Spina Bifida. The Irish Department of Health recommends that every woman in this country who is planning to become pregnant should take 600 micrograms of folic acid daily prior to conception, and for the first 12 weeks of her pregnancy. Folic acid, or folate, is a B Group vitamin which cannot be made by the body, so must be taken in dietary form or as a folic acid supplement in tablet form. It is found in green leafy vegetables such as cabbage, broccoli, lettuce, spinach and also in some breakfast cereals, bread, bananas, carrots, nuts and fish.

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