Spina bifida is the most frequently occurring permanently disabling birth defect. More children are affected by spina bifida than muscular dystrophy, multiple sclerosis and cystic fibrosis combined. This disease affects one out of every 1,000 newborns in the United States or about 8,000 newborns a year.
Spina bifida means split spine; a spine 'split' because the bones of the spinal column fail to enclose the spinal cord during the first trimester of pregnancy. In a normal spine development, the spine encloses and protects the spinal cord. The condition is often referred to as a neural tube defect. The malformation occurs between the third and and sixth, before many women have confirmed their pregnancy. During the first month of a normal pregnancy, the tissue that runs down the center of the embryo develops a groove. It's edges grow up and around until it forms a tube. The tube eventually sprats to form the brain and spinal cord. Supportive and protective tissues, also known as meninges, form to enclose the spinal cord and the brain. Later, the vertebrae form to protect the spinal cord, and the skull to protect the brain. In spina bifida, some section of the tube fails to close, resulting in the abnormal development of the meninges, nerves, and vertebrae. The vertebrae start to form in the middle and work their way up and down. With spina bifida, the building of the vertebrae stops before they are completely done forming.
There are three types of spina bifida, which range in their levels of severity. The most common and least severe is known as spina bifida occulta. In this type [of spina bifida,] there is an abnormal opening in the back because the back arches of the vertebrae did not fuse. The spinal cord and nerves are typically not damaged and neurological functions are usually still intact. At the site of the defect, there may be a dimple on the skin, tufts of hair or nothing visible at all. Many people with this form of spina bifida do not even know that they are affected. In some of these cases, problems with the bowel or bladder may occur and also with the motor control of the legs. The least common, but second in severity, is known as menengocele. In this type, the meninges are pushed through the opening in the vertebrae and form a sac. The sac is called [a] menengocele, and contains the meninges and cerebrospinal fluid. The spinal cord remains intact in this type of spina bifida. Is it treated with corrective surgery to reposition the meninges and remove the sac. After surgery, some sensory and motor handicaps may be present. The most serious type [of spina bifida], and the second most common, is myelomeningocele. This type of spina bifida usually causes serious impairment. The vertebrae fail to fuse and the meninges and spinal cord stick out to form a sac. Sometimes, the spinal cord doesn't develop properly and spinal nerves are damaged. Often times, the effects are not confined to the specific site where the sac is exposed. Although all three types of spina bifida can result in disabilities, there is always the chance that they will be minor.
Physicians do not know what causes spina bifida, but they believe [that] it could be a combination of environmental and genetic factors. Studies show that if a family member has spina bifida, anyone in [the] family has a higher chance of having a child with spinal bifida. According to new studies, the lack of folic acid in the mother's diet may also be a factor. The United States public health services recommend that 'all women of childbearing age in the US who are capable of becoming pregnant should consume 0.4mg of folic acid per day for the purposes of reducing their risk of having a pregnancy affected with spina bifida or other neural tube defects. Folic acid is a B vitamin that can be found in such foods as cereals, broccoli, spinach, corn and other [vegetables], including a vitamin supplement.
Spina bifida is accompanied by a variety of complications. It may cause a varying degree of paralysis and loss of feeling in the lower limbs. The bowels and bladder are also usually affected by spina bifida. A large percentage of kids born with spina bifida are also born with hydrocephalus. Hydrocephalus is an enlargement of the head caused by excess cerebrospinal fluid. It is controlled by a surgical procedure called shunting, which relieves the fluid built up in the brain by redirecting it into the abdominal area. Until recently, most children born with spina bifida died shortly after birth. Due to new surgical techniques, today, 85 to 90 percent of newborns survive.
Spina bifida has no symptoms, because it is a disease [one] is born with. However, there are several treatments for this incurable disease. For many children born with spina bifida, the initial surgeries are only the beginning. The children often have several more surgeries by the age of eighteen to straighten spines, lengthen muscles, and control severe bladder problems. Some children regularly participate in physical therapy to learn mobility skills in order to achieve independence. They learn how to use crutches, braces or wheelchairs to help them get around. However, some are able to walk on their own, without any support. Sometimes children with a history of hydrocephalus experience learning problems. Some learn special techniques to become independent by managing their own bowel and bladder problems with the help of a catheter. Children born with spina bifida are capable of becoming independent, productive adults.
There are a number od procedures available for prenatal detection of birth defects. One test tests the levels of alpha-fetoprotein (AFP) in an expectant mother's blood. AFP is produced in the liver of all people, including the developing fetus. A blood sample from the mother showing abnormally high concentration of AFP may indicate a possible birth defect. However, a high concentration can also result [from] the presence of twins. If the concentration is high, other tests will be required. An amniocentesis test involves inserting a needle into the amniotic sac and extracting a small quantity of amniotic fluid. An ultrasound is done during the procedure to avoid touching the fetus and causing injury. The extracted fluid is [then] analyzed to find out how much AFP is present inside the mother. Two other procedures include the use of a fiber optic microscope and x-ray. If tests confirm that the child has spina bifida, the parents have the option to terminating the pregnancy or carry the fetus to term. If the parents decide to keep the baby, arrangements are made to deliver the child at a regional medical center. This way, specialized services such as neurosurgery to repair the back and intensive care available. The baby is usually delivered by cesarean in order to prevent further damage. However, the tests do not always show that the child has spina bifida. For example [an acquaintance] has spina bifida, but none of the tests ever revealed the problem. She wasn't diagnosed with spina bifida until after birth.
Thousands of children are born with spina bifida each year. Sometimes the complications are severe and sometimes they are minor. In any case, the child can grow up to be an independent individual if they are just given the chance.
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