EARLY OUTCOME ANALYSIS OF NEURAL TUBE DEFECTS PRESENTING IN NEONATAL PERIOD: OUR EXPERIENCE

2021 ◽  
pp. 46-49
Author(s):  
Liladhar Agrawal ◽  
Rahul Gupta
Keyword(s):  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Postoperative Period ◽  
Neonatal Period ◽  
Tertiary Care ◽  
Shunt Operation ◽  
Female Ratio ◽  
Vp Shunt ◽  
Antenatal Ultrasonography

Background: Neural tube defects (NTDs) are congenital malformation resulting from failure of complete or partial closure of the neural tube in developing embryo. Aims and Objectives: The aim of this study is to present our experience, management and early outcomes (one month post-operatively) of neural tube defects presenting in neonatal period at our high volume tertiary care teaching Institutions. Materials and methods: This retrospective cohort study was conducted over a period of 10 years from January 2007 to December 2016. Medical records of neonates treated for neural tube defects were recorded in a pre-designed Performa. Results: A total of 286 patients with clinically diagnosed neural tube defects presenting in the neonatal period were studied. Male: female ratio was 1.11. The mean birth weight was 2350g. History of peri-conceptional use of folic acid was found in 15 (5.24%) mothers. One hundred seventeen (40.90%) of the patients had multiple system involvement. Most common was orthopedic deformities. Associated hydrocephalus was appreciated in 259 (90.56%) patients. Meningomyelocele was the most common anomaly seen in 239 (83.57%), 24 (8.39%) as meningocele and 23 (8.04%) were diagnosed as having Encephalocele. Surgery with decapping and repair was performed in 277 (96.85%) of the patients. Ventriculoperitoneal (VP) shunt operation before repair of meningomyelocele was performed in 9 (3.15%) patients, while in 19 (6.64%) patients, VP shunt operation was performed after the repair of NTD's in the early (one month) postoperative period. Clinical sepsis developed in the postoperative period in twenty one (7.58%) out of 277 patients, for which antibiotics were stepped up. Thirteen patients (4.69%) died postoperatively due to sepsis and associated anomalies. Conclusions: We present our retrospective report on neural tube defects from Indian subcontinent with accurate baseline data. Meningomyelocele was the most common type of NTD's. We recommend that folic acid supplementation should begin before marriage to raise its serum levels before the conception. Antenatal care especially antenatal ultrasonography must be contemplated as early as possible in early detection of NTDs.

scholarly journals Demography and management outcome of neural tube defects in a Nigerian tertiary health institution

2021 ◽  
Vol 9 (11) ◽  
pp. 3263
Author(s):  
Usman Babagana
Keyword(s):  
Folic Acid ◽  
Spina Bifida ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Folic Acid Deficiency ◽  
Female Ratio ◽  
Surgical Interventions ◽  
Number Of Patients ◽  
North Eastern ◽  
The Central Nervous System

Background: Neural tube defects (NTD) are a group of congenital anomalies of the central nervous system (CNS). Its management is very challenging. A recognised leading cause is a folic acid deficiency, therefore prevented by taking a preconception folic acid. This study looked at the demographic features and management outcome of neural tube defect, a fairly common preventable condition with the need to raise awareness on its preventive measures. Methods: The study was conducted on 82 patients with NTD that were managed in federal medical centre Yola, in North-Eastern Nigeria. It was a retrospective study over a 4-year period, from January 2016 to December 2019.Results: Ages at presentations ranged from 1 to 93 days with a mode of 3 days. There were 29 males and 53 females with a male to female ratio of 1:1.8. Spina bifida constituted 74.4%, encephalocele (20%), Anencephaly (5%). Types of spina bifida managed were myelomeningocele (63.5%), meningocele (33.3%), and lipo-myelomeningocele (3.2%). Two had a 2-level meningocele. Syndromic associations of myelomeningocele were with hydrocephalus (78.1%), foot deformity (22.2%), cardiac (2.5%), and anorectal malformation (2.5%). Ninety-five-point one had various surgeries with 30.8% developing postoperative complications. commonest was post excision of myelomeningocele and encephalocele hydrocephalus (29.1%) in 7 patients. Post-operative Mortality was reported in 2 patients (8.3%).Conclusions: Myelomeningocele was the commonest NTD, and its syndromic association with hydrocephalus was common. A large number of patients had surgical interventions with a good outcome. Post-op mortality was minimal. 

scholarly journals Incidence and Trends of Neural Tube Defects in Babies Delivered at Dera Ghazi Khan Tertiary Care Center

2021 ◽  
Vol 24 (4) ◽  
pp. 399-404
Author(s):  
Syed Shahid Bokhari ◽  
Muhammad Asif Qureshi
Keyword(s):  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Neural Tube Defect ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Tertiary Care Center ◽  
Folic Acid Intake ◽  
Acid Intake

Objective:  A cross-section study was conducted to determine the incidence and trends of neural tube defects in babies delivered at a tertiary care center. And those babies who were delivered elsewhere and were brought to a tertiary care center for treatment. Material and Methods:  The Study was conducted at neurosurgery and pediatric surgery departments, Ghazi Khan Medical College and Teaching Hospital. Two thousand (n = 2000) women delivered their babies at a tertiary care hospital were enrolled, out of them 52 women who delivered babies with neural tube defects (NTDs) were further assessed. Women were interviewed and history of folic acid intake, previous baby with NTDs and family history were recorded. Tests of significance were applied to assess the significant results. Results:  Folic acid intake was occurred in n = 298 (14.9%) subjects. Association of folic acid on neural tube defects. Odds ratio showed that if a baby without intake of folic acid had 7.8 times at risk to suffer from a neural tube defect. The association was also significant (p = 0.000). Conclusion:  Neural tube defects are common in tertiary care centers its incidence was 2%. Increased incidence of NTDs was observed in babies who delivered by folic acid deficit mothers. Early childhood marriages in rural areas and cousin marriages are the main contributing factors. Keywords:  Neural tube defect, Anencephaly, Spina bifida, Hydrocephalus, Meningocele.

scholarly journals Prenatal Ultrasonographic and Magnetic Resonance Imaging Diagnosis of Occipital Meningio-Encephalocele- An Interesting Case Report

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2332-2335
Author(s):  
Karthik Krishna Ramakrishnan ◽  
Ashwini Govisetty ◽  
Naveen Nagendran ◽  
Meyyappan Meenakshisomasundaram ◽  
Paarthipan Natarajan ◽  
...  
Keyword(s):  
Congenital Anomaly ◽  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Fetal Mri ◽  
Folic Acid Supplementation ◽  
Interesting Case ◽  
Fetal Anomalies ◽  
Surface Ectoderm ◽  
Antenatal Ultrasonography

Meningo encephalocele is a congenital anomaly and is a neural tube defect with occipital meningo encephalocele being the most common and is a result of a failure of the surface ectoderm to separate from the neuroectoderm. This condition can be identified in 1st trimester in 80% of cases and almost all by 2nd trimester. A 20-year-old third gravida was referred for antenatal Ultrasonography at five months of amenorrhoea to rule out fetal anomalies. On targeted imaging, for fetal anomalies, a defect was seen in occipital bone with herniation of posterior fossa contents with overlying meningeal covering. No other fetal anomalies were noted. A diagnosis of isolated occipital meningoencephalocele was made with additional fetal MRI correlation. The mother underwent termination of her pregnancy by Department of Obstetrics and Gynecology because of the grim fetal prognosis. The mother was advised to plan the subsequent pregnancies and was advised pre-conceptional folic acid supplementation. We present a case of isolated occipital meningoencephalocele- a rare congenital anomaly which was diagnosed prenatally in our hospital. This case provides an opportunity for identifying such neurological defects early and prompt termination of pregnancy to prevent comorbidity to mother. This study also helps to establish occipital meninigioencephalocele as an isolated clinicoradiological diagnosis and to distinguish it from syndrome associated occipital meninigioencephalocele or those associated with other neural tube defects like Chiari III malformations. It also allows us to stress once again the role of periconceptional folic acid in preventing the occurrence of neural tube defects.

A Public Health Success Story: Folic Acid Fortification and Supplementation for Prevention of Neural Tube Defects

2004 ◽  
Author(s):  
Linda Longerich ◽  
Roy West ◽  
Ed Randell ◽  
Marian Crowley ◽  
Shiliang Liu ◽  
...  
Keyword(s):  
Public Health ◽  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Success Story ◽  
Folic Acid Fortification

scholarly journals Knowledge and intake of folic acid to prevent neural tube defects among pregnant women in urban China: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mingming Cui ◽  
Xiao-Lin Lu ◽  
Yan-Yu Lyu ◽  
Fang Wang ◽  
Xiao-Lu Xie ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Unplanned Pregnancy ◽  
Urban China ◽  
Cross Sectional

Abstract Background The prevalence of neural tube defects (NTDs) in China declined during 2000–2017 with periconceptional folic acid (FA) supplementation, which is effective in reducing the risk of birth defects. We aimed to assess the knowledge and actual use of FA among Chinese pregnant women and to explore factors associated with FA use before pregnancy. Methods All data were collected in face-to-face interviews during health visits among pregnant women. We collected information about knowledge and use of FA supplements and demographic, socioeconomic, and health status. One maternity and childcare hospital was chosen in each of four cities: Beijing, Huaibei, Kunming, and Haikou. In total, 435 pregnant women were randomly recruited for interviews conducted from June to December 2016. Results A total of 428 pregnant women were included in this survey. Of these, 82.0% (351/428) knew that FA can prevent NTDs, and 75.9% (325/428) knew the correct time to take FA. Overall, 65.9% (282/428) of women knew both that FA can prevent NTDs and the recommended time to take FA before pregnancy. Approximately 95.1% (407/428) of women reported having ever taken FA, only 46.3% (198/428) had begun to take FA supplementation before conception, and 64.5% (109/169) of women from rural areas failed to take FA before pregnancy. Women living in northern China (odds ratio [OR] = 1.81, 95% confidence interval [CI], 1.18–2.77), those with unplanned pregnancy (OR = 1.99, 95% CI 1.30–3.04), and highly educated women (OR = 2.37, 95% CI 1.45–3.88) were more likely to know about FA. Women who were homemakers (OR = 1.94, 95% CI 1.21–3.11) and had unplanned pregnancy (OR = 6.18, 95% CI 4.01–9.53) were less likely to begin taking FA before pregnancy. Conclusions Our survey showed that most pregnant women knew about FA. Although preconception intake of FA can help to reduce NTDs, improving the rate of FA intake before pregnancy is needed in urban areas of China, especially among homemakers and women from rural areas or with unplanned pregnancy. Campaigns are needed to increase awareness about FA and FA use before pregnancy among rural women, homemakers, and those with unplanned pregnancy and lower education levels.

scholarly journals More on folic acid and neural tube defects.

1995 ◽  
Vol 85 (2) ◽  
pp. 269-269
Author(s):  
M M Werler ◽  
A A Mitchell
Keyword(s):  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects
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