Spina Bifida

What is Spina Bifida?
Spina Bifida basically means ‘Split Spine’. There are 33 vertebrae in the spine and if one or more of these or the neural tube do not form properly in the womb during early weeks of pregnancy it may cause the nerves in the spine to be unprotected and therefore cause damage to the central nervous system.

There are three types of spina bifida:

Spina Bifida Occulta (Hidden)
This is the common form of spina bifida, it is also normally very mild.  Hidden Spina Bifida may affect up to one in ten people and many may not even know they have it.  This is when there is a very small gap between the vertebrae. Many people have no symptoms at all.  The only visible signs may be a small dimple on the back or a problem with no hair growth on that tiny area.

Spina Bifida myelomeningocele
This can be very serious.  A cyst or a sac can usually be seen on the back even though it is covered by skin, sometimes it looks like a blister, with tissues and nerves inside. The spinal cord did not develop properly. Children with this form of spina bifida will have hydrocephalus,which is where the fluid which surrounds the brain is unable to drain out into the bloodstream. Parts of the brain are also damaged before birth which also stops the fluid draining properly; this causes the brain to be compressed.

It is likely that people with this type of Spina Bifida may have some paralysis as well as nerve damage.  It may cause them to be unable to walk or have control of their bladder.

Approximately one baby in every 1000 is born with this type of spina bifida.

Spina Bifida meningocele
This is the rarest type of spina bifida and much less serious than meningomyelocele.  A person will have a cyst that contains membranes.  It is possible that this cyst will rupture.  Your doctor will be aware of the cyst and will give you advice and information on what to do.

What causes it and when will I find out if my baby has it?
It is still unknown exactly what causes Spina Bifida although it is likely to be a mixture of genetic and environmental factors.

Recently it has been discovered that a fault in the LPP1 Gene may cause the severe form of Spina bifida. If you have spina bifida or have a child with spina bifida there is a 1 in 25 chance of having another child with the condition.

During your pregnancy you will be offered antenatal scans and screening tests to detect the condition. Your midwife will explain what the tests involve and will be able to answer any question that you may have.

Treatment and Preventions
If a baby is born with a severe case of spina bifida they will need surgery within two days to try and repair the gap in the spine. In some cases and in some hospitals, the doctors prefer to leave the area to heal by itself.

If a baby is born with hydrocephalus, they may need to have a hollow tube fitted to help drain the extra fluid from their brain. Seeing a physiotherapist can help with any mobility problems that the child has. Exercises and massages may be demonstrated for daily use.

Emotional support is also very important for the parents and family.  Your midwife and health visitor will help, give advice and show you where you can get more help and information from.

Whilst you are pregnant and before you conceive, you can help reduce the risk of having a baby with spina bifida by taking a daily supplement of 400micrograms of folic acid.  This is very important in the first few weeks of pregnancy.

If you would like more information, speak to your midwife or health visitor.

by Jenny, mum to William and James

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