The detection of neural tube defects frequently occurs before delivery as a result of maternal alphafetoprotein measurement or ultrasound examination. Referral to a multidisciplinary team for family counselling and management plan development is then appropriate. Genetics Health Services Victoria provides services throughout Victoria and can be contacted via (03) 8341 6201.
Occasionally affected infants will deliver unexpectedly. Prognosis for survival and extent of the disability depend on
Meningocele is a herniation of meninges without associated neural tissue through the bony defect. Following surgical repair there is a good prognosis. Diagnosis is made by appropriate imaging studies (eg ultrasound).
Detailed clinical examination is required to assess
Infants need referral and transport to a neonatal centre for assessment by a co-ordinated team of specialists experienced in dealing with these lesions so that a treatment policy can be discussed with the parents.
Before and during transport
IV access is required to provide antibiotics e.g. Penicillin and Gentamicin (preferably after blood is taken for culture).
Fetal surgery to close the defect and thus possibly reduce the incidence of hydrocephalus and long term neurological complications remains experimental.
Cesarean section before the onset of labour is usually the desired mode of delivery since this has been associated with improved neurological outcomes.
http://www.spinabifida.org This is the Home page of the Spina Bifida Hydrocephalus Association of Queensland. Its great. Plenty of information and good diagrams.
http://www.sbaa.org/index.shtml This is the Home page of the Spina Bifida Association of America. Its very good.
Neural Tube Defects in the Neonatal Period Ellenborgen R.G. eMedicine Journal, July32001, Vol.2, No. 7 http://www.emedicine.com/ped/topic2805.htm