Spina bifida – a follow-up study of neonates born from 1991 to 2001
-
Krzysztof Preis
Abstract
Aims. To follow the development of children born with myelomeningocoele.
Methods. We followed 54 infants born with myelomeningocele between 1991 and 2001 in the Obstetrical Department of the Medical University of Gdansk, Poland.
Results. The mortality rate for live births was 40.8%. 13.0% of the children were stillborn and 5.5% were lost for observation. Late diagnosis, a high localization of the lesion, the presence of other malformations, and low birth weight increased the risk of death. Diagnosis was most commonly made in the 31–35th week of pregnancy. For 18.5% of the subjects, the diagnosis was postnatal. There was no correlation between the time and mode of delivery and mental development. Only some of the children were able to walk, to use braces, or use a wheelchair. Most of the children had poor bladder and bowel control. We found a correlation between these dysfunctions and the level of myelomeningocele.
Conclusions. Myelomeningocoele is associated with high rates of mortality and severe psychomotoric retardation. The localization of the lesion has an impact on survival rate and sphincter control. Mental development depends on neonatal condition after delivery. Mode of delivery does not influence the child's further development.
References
1 Bartecki B: Rehabilitation in children with myelomeningocoele. XVI Symposium of Polish Society of Pediatric Surgery Gorzow 1991, 41Suche in Google Scholar
2 Bruner JP, N Tulipan, RL Paschal: Fetal Surgery for Myelomeningocoele and the Incidence of Shunt-Dependent Hydrocephalus. JAMA282 (1999) 1819Suche in Google Scholar
3 Chervenak FA, L Duncan, IR Ment: Perinatal management of myelomeningocoele. Obstet Gynecol63 (1984) 376Suche in Google Scholar
4 Cochrane D, B Irwin, K Chambers: Clinical outcomes that fetal surgery for myelomeningocoele needs to achieve. Eur J Pediatr Surg11 Suppl I (2001) 1810.1055/s-2001-19738Suche in Google Scholar
5 Hunt G: Open spina bifida: The Cambridge cohort in their twenties. Eur J Pediatr Surg2Suppl I (1992) 39Suche in Google Scholar
6 Kolble N, TAG Huisman, M Stallmach, M Meuli, FZR Imahorn, R Zimmermann: Prenatal diagnosis of the fetus with lumbal myelocystocoele. Ultrasound Obstet Gynecol18 (2001) 536Suche in Google Scholar
7 Liu SL, DB Shurtleff, RG Ellenbogen JD Loser, R Kropp: 19-year Follow-up of fetal myelomeningocoele brought to term. Eur J Pediatr Surg9Suppl I (1999) 1210.1055/s-2008-1072304Suche in Google Scholar
8 Lodzinski K: Dysrrhaphia. In: Poradowska W: Pediatric surgery. PZWL, Warsaw 1992Suche in Google Scholar
9 Lodzinski K, Z Dudkiewicz, S Jaworski: Evolution of myelomeningocoele treatment. XVI 9. Symposium of Polish Society of Pediatric Surgery Gorzow (1991) 17Suche in Google Scholar
10 Mac Mahon RA: Pediatric Surgery. PZWL, Warsaw 1990Suche in Google Scholar
11 Marianowski L, R Debski: Prenatal diagnosis of congenital malformations. Ultrasonografia Pediatryczna (1999) 364Suche in Google Scholar
12 McLone DG, TP Naidich: Myelomeingocoele: outcome and late complications. Ped Neurosurg: Surgery of the Developing Nervous System. Saunders, Philadephia1989, pp 53Suche in Google Scholar
13 Mirzai H, Y Ersahin, S Mutluer, A Kayahan: Outcome of patients with myelomeningocoele. Child's Nerv Syst14 (1998) 120Suche in Google Scholar
14 Osemlak J: Morphology and classification of dysrrhaphic malformations of central nervous system. Ped Pol9–10 (1992); Suppl 466Suche in Google Scholar
15 Polis L, K Szaflik: In utero treatment of hydrocephaly. Neurologia Dziecieca, 816 (1999) 23Suche in Google Scholar
16 Ralis ZA: Traumatizing effect of breech delivery on infants with spina bifida. J Pediatr87 (1975) 61310.1016/S0022-3476(75)80838-9Suche in Google Scholar
17 Roszkowski T: Diagnosis of fetal malformations. Klinika5; 1 (1998) 33Suche in Google Scholar
18 Roszkowski M, S Barszcz, Z Turkowski: Operative cerebral endoscopy in hydrocephaly treatment. Neur Neurochir Pol31 (1997) 805Suche in Google Scholar
19 Roszkowski M, L Skobejko, S Barszcz: Diagnosis and surgical treatment of Tethered spine syndrome. Postepy pediatrii; LXXI2(1996) 135Suche in Google Scholar
20 Stark G, M Drummond: Spina bifida as an obstetric problem. Develop Med Child Neurol Suppl22 (1970) 157Suche in Google Scholar
21 Steinbok P, B Irvine, D Cohrane, BJ Irvin: Long-term outcome and complications of children born with myelomeningocoele. Child's Nerv Syst8 (1992) 92Suche in Google Scholar
22 Sutton LN, NS Adzick, LT Bilaniuk: Improvement in hindbrain herniation demonstrated by serial fetal magnetic resonance imaging following fetal surgery for myelome-ningocoele. JAMA282 (1999) 1826Suche in Google Scholar
23 Szaflik K: Intensive fetal therapy. In: Breborowicz GH: High Risk Pregnancy. PAN, Poznan 2000Suche in Google Scholar
24 Wilczynski J, K Szaflik, M Respondek-Liberska, T Stetkierwicz: Malformations of the fetus – management. In: Breborowicz GH: High Risk Pregnancy. PAN, Poznan 2000Suche in Google Scholar
25 Wocjan J: Congenital nervous system malformations and genetic disorders. In: Bidzinski J: Neurosurgery. PZWL, Warsaw 1998Suche in Google Scholar
26 Wosko IP: Orthopedic and rehabilitation problems in children with myelomeningocoele. Folium, Lublin 1995Suche in Google Scholar
© Walter de Gruyter
Artikel in diesem Heft
- The epidemiology of preterm labor – a global perspective
- Erythropoietin and prematurity – where do we stand?
- The quality of nifedipine studies used to assess tocolytic efficacy: a systematic review
- Unexplained intrauterine fetal death is accompanied by activation of complement
- Anaphylatoxins in preterm and term labor
- The transcription factor Ets-1 is expressed in human amniochorionic membranes and is up-regulated in term and preterm premature rupture of membranes
- Recombinant human lactoferrin has preventive effects on lipopolysaccharide-induced preterm delivery and production of inflammatory cytokines in mice
- Laparoscopic and vaginal repair of uterine scar dehiscence following cesarean section as detected by ultrasound
- Cerebral ventricular volume assessment by three-dimensional ultrasonography
- Nomogram of the fetal gastric size development in normal pregnancy
- Therapeutic hypothermia: from lab to NICU
- Alveolar capillary dysplasia: a six-year single center experience
- Spina bifida – a follow-up study of neonates born from 1991 to 2001
- Concordant occipital encephalocele in monoamniotic twins
- Changes of lactate, glucose, ionized calcium and glutamate concentrations in cephalic vein blood during brain hypothermia using extracorporeal membrane oxygenation (ECMO) in a newborn infant with hypoxic-ischemic encephalopathy
- Treatment of symptomatic congenital cytomegalovirus infection with valganciclovir
- A coiled nasogastric tube in a newborn
Artikel in diesem Heft
- The epidemiology of preterm labor – a global perspective
- Erythropoietin and prematurity – where do we stand?
- The quality of nifedipine studies used to assess tocolytic efficacy: a systematic review
- Unexplained intrauterine fetal death is accompanied by activation of complement
- Anaphylatoxins in preterm and term labor
- The transcription factor Ets-1 is expressed in human amniochorionic membranes and is up-regulated in term and preterm premature rupture of membranes
- Recombinant human lactoferrin has preventive effects on lipopolysaccharide-induced preterm delivery and production of inflammatory cytokines in mice
- Laparoscopic and vaginal repair of uterine scar dehiscence following cesarean section as detected by ultrasound
- Cerebral ventricular volume assessment by three-dimensional ultrasonography
- Nomogram of the fetal gastric size development in normal pregnancy
- Therapeutic hypothermia: from lab to NICU
- Alveolar capillary dysplasia: a six-year single center experience
- Spina bifida – a follow-up study of neonates born from 1991 to 2001
- Concordant occipital encephalocele in monoamniotic twins
- Changes of lactate, glucose, ionized calcium and glutamate concentrations in cephalic vein blood during brain hypothermia using extracorporeal membrane oxygenation (ECMO) in a newborn infant with hypoxic-ischemic encephalopathy
- Treatment of symptomatic congenital cytomegalovirus infection with valganciclovir
- A coiled nasogastric tube in a newborn
