Skip to main content
UploadLanguage (EN)Support
BusinessMobileSocial MediaMarketingTechnologyArt & PhotosCareerDesignEducationPresentations & Public SpeakingGovernment & NonprofitHealthcareInternetLawLeadership & ManagementAutomotiveEngineeringSoftwareRecruiting & HRRetailSalesServicesScienceSmall Business & EntrepreneurshipFoodEnvironmentEconomy & FinanceData & AnalyticsInvestor RelationsSportsSpiritualNews & PoliticsTravelSelf ImprovementReal EstateEntertainment & HumorHealth & MedicineDevices & HardwareLifestyle
Uploaded byArpitaHalder8
PPTX, PDF418 views

Spina Bifida (2).pptx2222222222222222222

Spina bifida is a neural tube defect characterized by improper formation of the spine and spinal cord, which can range from mild to severe forms, such as spina bifida occulta and myelomeningocele. Risk factors include genetic predisposition, folate deficiency, and maternal health issues, with symptoms varying by severity and type. Preventative measures, particularly folic acid supplementation before and during early pregnancy, can significantly reduce the occurrence of this defect.

Health & Medicine◦
Download to read offline
Spina bifida is a birth defect that occurs when the spine and spinal cord don't form properly. It falls under the broader category of neural tube defects. The neural tube is the embryonic structure that eventually develops into the baby's brain and spinal cord and the tissues that enclose them.
• Normally, the neural tube forms early in pregnancy, and it closes by the 28th day after conception. • In babies with spina bifida, a portion of the neural tube fails to develop or close properly, causing defects in the spinal cord and in the bones of the spine. • Spina bifida can range from mild to severe, depending on the type of defect, size, location and complications. • When early treatment for spina bifida is necessary, it's done surgically, although such treatment doesn't always completely resolve the problem.
Types • Spina bifida occulta • Spina bifida cystica  Meningocele  Myelomeningocele
Spina bifida occulta "Occulta" means hidden. The mildest form, spina bifida occulta results in a small separation or gap in one or more of the bones of the spine (vertebrae). Many people who have spina bifida occulta don't even know it, unless the condition is discovered during an imaging test done for unrelated reasons.
Meningocele In a form of spina bifida called meningocele, the protective membranes around the spinal cord (meninges) push out through the opening in the vertebrae, forming a sac filled with fluid. But this sac doesn't include the spinal cord, so nerve damage is less likely, though later complications are possible.
Myelomeningocele Also known as open spina bifida, myelomeningocele is the most severe form. The spinal canal is open along several vertebrae in the lower or middle back. The membranes and spinal nerves push through this opening at birth, forming a sac on the baby's back, typically exposing tissues and nerves. This makes the baby prone to life-threatening infections.
Causes Unknown causes spina bifida. As with many other problems, it appears to result from a combination of genetic and environmental risk factors, such as a family history of neural tube defects and folate deficiency.
Risk factors Spina bifida is more common among whites and Hispanics, and females are affected more often than males. Folate (vitamin B-9) is important to the healthy development of a baby. Folate is the natural form of vitamin B-9. The synthetic form, found in supplements and fortified foods, is called folic acid. A folate deficiency increases the risk of spina bifida and other neural tube defects. of neural tube defects. Couples who've had one child with a neural tube defect have a slightly higher chance of having another baby with the same defect.
Women with diabetes who don't control their blood sugar well have a higher risk of having a baby with spina bifida. Pre-pregnancy obesity is associated with an increased risk of neural tube birth defects, including spina bifida. Some evidence suggests that increased body temperature (hyperthermia) in the early weeks of pregnancy may increase the risk of spina bifida. Elevating body temperature, due to fever or the use of saunas or hot tubs, has been associated with a possible slight increased risk of spina bifida.
Symptoms Signs and symptoms of spina bifida vary by type and severity. Symptoms can also differ for each person. Because the spinal nerves usually aren't involved, typically there are no signs or symptoms. But visible indications can sometimes be seen on the newborn's skin above the spinal defect, including an abnormal tuft of hair, or a small dimple or birth mark.
The membranes around the spinal cord push out through an opening in the vertebrae, forming a sac filled with fluid, but this sac doesn't include the spinal cord.
Myelomeningocele. • In this severe form of spina bifida: The spinal canal remains open along several vertebrae in the lower or middle back. • Both the membranes and the spinal cord or nerves protrude at birth, forming a sac. • Tissues and nerves usually are exposed, though sometimes skin covers the sac. Children with spina bifida occulta typically don't have any symptoms or complications, so usually only routine pediatric care is needed.
Blood tests For the MSAFP test, a sample of the mother's blood is drawn and tested for alpha-fetoprotein (AFP) — a protein produced by the baby. It's normal for a small amount of AFP to cross the placenta and enter the mother's bloodstream. But abnormally high levels of AFP suggest that the baby has a neural tube defect, such as spina bifida, though some spina bifida cases don't produce high levels of AFP. Diagnosis
May perform the MSAFP test with two or three other blood tests. These tests are commonly done with the MSAFP test, but their objective is to screen for other abnormalities, such as trisomy 21 (Down syndrome), not neural tube defects. Many obstetricians rely on ultrasonography to screen for spina bifida. If blood tests indicate high AFP levels, will suggest an ultrasound exam to help determine why. The most common ultrasound exams bounce high-frequency sound waves off tissues in body to form images on a video monitor. If a blood test shows high levels of AFP in blood but the ultrasound is normal,may offer amniocentesis. During amniocentesis,uses a needle to remove a sample of fluid from the amniotic sac that surrounds the baby.
Treatment Surgery before birth Nerve function in babies with spina bifida can worsen after birth if it's not treated. Prenatal surgery for spina bifida (fetal surgery) takes place before the 26th week of pregnancy. Expose a pregnant mother's uterus surgically, open the uterus and repair the baby's spinal cord. Research suggests that children with spina bifida who had fetal surgery may have reduced disability and be less likely to need crutches or other walking devices.
Many babies with myelomeningocele tend to be in a feet-first (breech) position. If baby is in this position or if has detected a large cyst or sac, cesarean birth may be a safer way to deliver baby.
• Meningocele involves surgery to put the meninges back in place and close the opening in the vertebrae. • Because the spinal cord develops normally in babies with meningocele, these membranes often can be removed by surgery with little or no damage to nerve pathways.
Myelomeningocele also requires surgery. • Performing the surgery early can help minimize risk of infection that's associated with the exposed nerves and may also help protect the spinal cord from more trauma. • During the procedure, a places the spinal cord and exposed tissue inside the baby's body and covers them with muscle and skin. • Sometimes a shunt to control hydrocephalus in the baby's brain is placed during the operation on the spinal cord.
Surgery for hydrocephalus.
• Most babies with myelomeningocele will need a ventricular shunt — a surgically placed tube that allows fluid in the brain to drain into the abdomen. • This tube might be placed just after birth, during the surgery to close the sac on the lower back or later as fluid accumulates. • A less invasive procedure, called endoscopic third ventriculostomy, may be used, but candidates must be carefully chosen and meet certain criteria. • The surgeon uses a small video camera to see inside the brain and makes a hole in the bottom of or between the ventricles so cerebrospinal fluid can flow out of the brain.
The nerves that control the leg muscles don't work properly below the area of the spina bifida defect, causing muscle weakness of the legs, sometimes involving paralysis. Whether a child can walk typically depends on where the defect is, its size, and the care received before and after birth. Children with myelomeningocele can have a variety of problems in the legs and spine because of weak muscles in the legs and back. The types of problems depend on the level of the defect. Possible problems include a curved spine (scoliosis), abnormal growth or dislocation of the hip, bone and joint deformities, muscle contractures and other orthopedic concerns. Complications
• Nerves that supply the bladder and bowels usually don't work properly when children have myelomeningocele. This is because the nerves that supply the bowel and bladder come from the lowest level of the spinal cord. • Accumulation of fluid in the brain (hydrocephalus). Babies born with myelomeningocele commonly experience accumulation of fluid in the brain, a condition known as hydrocephalus. • Shunts can stop working or become infected. Warning signs may vary. • Some of the warning signs of a shunt that isn't working include headaches, vomiting, sleepiness, irritability, swelling or redness along the shunt, confusion, changes in the eyes (fixed downward gaze), trouble feeding, or seizures.
• Chiari malformation type II is a common brain abnormality in children with the myelomeningocele form of spina bifida. • The brainstem, or lowest part of the brain above the spinal cord, is elongated and positioned lower than usual. • This can cause problems with breathing and swallowing. Rarely, compression on this area of the brain occurs and surgery is needed to relieve the pressure. • Some babies with myelomeningocele may develop meningitis, an infection in the tissues surrounding the brain. • This potentially life-threatening infection may cause brain injury.
• Tethered spinal cord results when the spinal nerves become bound to the scar where the defect was closed surgically, making the spinal cord less able to grow as the child grows. • This progressive tethering can cause loss of muscle function to the legs, bowel or bladder. Surgery can limit the degree of disability. • Both children and adults with spina bifida, particularly myelomeningocele, may have sleep apnea or other sleep disorders. • Assessment for a sleep disorder in those with myelomeningocele helps detect • sleep-disordered breathing, such as sleep apnea, which warrants treatment to improve health and quality of life.
• Children with spina bifida may get wounds on their feet, legs, buttocks or back. They can't feel when they get a blister or sore. • Sores or blisters can turn into deep wounds or foot infections that are hard to treat. Children with myelomeningocele have a higher risk of wound problems in casts. • Children with spina bifida have a higher risk of latex allergy, an allergic reaction to natural rubber or latex products. Latex allergy may cause rash, sneezing, itching, watery eyes and a runny nose. • It can also cause anaphylaxis, a potentially life-threatening condition in which swelling of the face and airways can make breathing difficult. • So it's best to use latex-free gloves and equipment at delivery time and when caring for a child with spina bifida.
• More problems may arise as children with spina bifida get older, such as urinary tract infections, gastrointestinal (GI) disorders and depression. • Children with myelomeningocele may develop learning disabilities, such as problems paying attention, and difficulty learning reading and math.
Prevention Folic acid, taken in supplement form starting at least one month before conception and continuing through the first trimester of pregnancy, greatly reduces the risk of spina bifida and other neural tube defects. It's critical to have enough folic acid in system by the early weeks of pregnancy to prevent spina bifida. Because many women don't discover that they're pregnant until this time, experts recommend that all women of child bearing age take a daily supplement of 400 micrograms (mcg) of folic acid. Several foods, including enriched bread, pasta, rice and some breakfast cereals, are fortified with 400 mcg of folic acid per serving. Folic acid may be listed on food packages as folate, which is the natural form of folic acid found in foods.
Long Term Out Look Coping and support • Newborn child has a condition such as spina bifida can naturally cause to feel grief, anger, frustration, fear and sadness. • There's good reason to hope, however, because most people with spina bifida live active, productive and full lives — especially with encouragement and support from loved ones. • Independent mobility is an important and appropriate goal for all children with spina bifida. This may mean walking with or without braces, using walking aids (such as canes or crutches) or exclusively using a wheelchair. • They benefit from encouragement to participate in activities with their peers, and caregivers can help adjust activities to accommodate physical limitations.
Nursing diagnosis- Preoperative:- • Risk for injury & infection to the sac. • Impaired bladder & bowel function related to neurological deficit. Post operative-  Ineffective thermoregulation related to surgery.  Risk of development of infection related to surgery.  Altered nutrition less than body requirement related to disease process.  Risk of develpment of complication related to the disease process.  Altered bladder & bowel function related to neurological deficit.
Conclusion
Sarvodaya College Of Nursing ID:6409236325 PW:19586
Spina Bifida (2).pptx2222222222222222222