Spina Bifida; The Basic and Clinical Review

Abstract

Spina Bifida (SB) is a neural tube defect (NTD) due defect in neural tube, characterized by incomplete closure of spinal column. Occurrence of SB varies in different countries. In developed countries, it is about 0.4 per 1000 births, in US 0.7 per 1000 births and in Asia 1.9 per 1000 births. SB mostly occurs during first trimester of pregnancy. Variants of SB are Spina bifida Occulata, Spina bifida Cystica [meningocele and myelomeningocele], Spina bifida Manifesta and Spina bifida Aperta. Among these myelomeningocele is the most common type. Causing agents of SB may be genetic, non-genetic or environmental factors. Non-genetic factors involve anti-convulsant drugs, anti-epileptic drugs, maternal obesity, maternal diabetes and poor nutritional status (folate and vitamin B12 deficiency). Environmental factors are pesticides, nitrated compounds and air pollution. Common manifestations are brain malformations (Arnold Chiari II malformation and hydrocephalus), spinal cord abnormalities, latex allergy, breathing problems, urological abnormalities and cardio-metabolic dysfunction. Diagnostic techniques for Spina bifida are ultrasound screening, Magnetic Resonance Imagining (MRI), amniocentesis and maternal serum alpha-fetoprotein. To prevent the risk of Spina bifida, it is recommended for the mother to use 0.4mg of folic acid per day or in mothers affected with multiple pregnancies recommended dose of folic acid is 4mg per day.