Spina Bifida in Babies – Symptoms, Diagnosis And Treatment

This condition can emerge anywhere on the spine. Sometimes it emerges as an open space in the back of the baby. And sometimes it can have a fluid-filled sack on the back of the baby from where you can see the spinal cord inside.

Causes of Spina Bifida in Babies

Spina Bifida is mostly a genetic defect. If the mother already has a child with Spina Bifida then there are 4% more chances that the next baby will have the same defect. But sometimes the deficiency of folic acid or vitamin B-9 can also cause spina bifida in babies who have no such genetic factors involved.

Other factors that can enhance the chances of Spina Bifida are

• Uncontrolled diabetes of the mother
• Obesity
• Some types of medication

Symptoms of Spina Bifida in Infants

The symptoms of Spina Bifida vary according to its location on the spine. The higher its location is the more severe the condition will be. The symptoms of Spina Bifida are:

• A small opening in the spinal region on the back
• A gap in between the joining of vertebrae
• Open and visible spinal canal at the middle or low end of the back
• The emergence of a fluid-filled skin sack with or without the spinal cord and nerves within
• Seizures
• Curved spine
• Weak, undeveloped or paralyzed leg muscles
• Deformed feet
• Uneven hips
• Dysfunction in bowel and bladder
• Tiny birthmark or a dimple or a cluster of hair or a thick fat area on the back in the case of Spina Bifada Occulta

Types of Spina Bifida

There are three types of Spina Bifida depending on the severity of it. They are termed Myelomeningocele, Meningocele, and Spina Bifida Occulta.

1. Myelomeningocele

It is the most severe case of Spina Bifida. In this, a sack appears anywhere on the baby’s back from the empty section of the spine. Here the fluid-filled sack contains the spinal cord and nerves. Due to continuous contact with the amniotic fluid, the spinal cord and nerves get damaged. As a result, Myelomeningocele causes severe physical dysfunctions like lower-body paralysis, incontinence, etc.

2. Meningocele

In this type also a sack emerges at the back of the baby’s spine but here the sack does not contain the spinal cord and nerves. As a result, the spinal cord does not have any damage and the disabilities remain minimal.

3. Spina Bifida Occulta

It is called hidden spina bifida as there no outward signs to recognize it. There will be no open area on the baby’s back, just a gap in the spine unrecognizable without an x-ray. It is not so dangerous and does not cause any physical disability as the spinal cord and nerves remain intact. Sometimes it remains unnoticed until later in life.

[Read : What Causes Anencephaly During Pregnancy?]

Diagnosis of Spina Bifida in Babies

Both the Myelomeningocele and Meningocele types of Spina Bifida can be diagnosed during pregnancy. But the Spina Bifida Occulta may sometimes remain unnoticed until adulthood or not be diagnosed at all.

During pregnancy, some prenatal tests and ultrasounds can recognize if there is any spina bifida or other birth defects.

These tests are

1. AFP

In this blood test, the mother’s blood will be taken to measure the amount of alpha-fetoprotein or AFP in it. This protein is released by the unborn baby but an increase in AFP suggests Spina Bifida.

2. Ultrasound

The sack of open space in the spine can be diagnosed through the routine USG.

3. Amniocentesis

In Amniocentesis test, the doctor will take a sample of the amniotic fluid to measure the AFP in it. It is more reliable than the AFP blood test.

4. Physical Examination of The Baby

Spina Bifida Occulta is diagnosed by a hairy patch, dimple or a small birthmark on the back. Then the doctor will take an x-ray, CT scan or MRI to confirm it.

Treatment For Spina Bifida in Infants

Different types of Spina Bifida require different treatments. As the Myelomeningocele and the Meningocele types are most severe they require surgery to remove the sack and place the spinal cord and nerves back in their place. There may be a shunt put in the place of open vertebrae to avoid further complications. In some cases, prenatal surgery can be possible, but it is a bit risky. In severe cases even after the surgery paralysis and problems with the bowel and bladder functions will remain for life.

Prognosis of Babies With Spina Bifida

According to the Children’s Hospital of Philadelphia, about 14% of the infants with Myelomeningocele die before 5 years. It causes due to hindbrain herniation complications which cause an accumulation of cerebrospinal fluid in the brain. About 85% of cases require shunts during surgery and in 45% of cases, these shunts create complications within 1 year of surgery.

So, Spina Bifida is a serious birth defect and most of the time cannot be prevented as it starts at a very early stage of pregnancy. So as a preventive measure, you can take green leafy vegetables to ensure enough intake of vitamin B-9 or folic acid. Keep your diabetes in check and reduce overweight before conception. This will lessen the chances of Spina Bifida.

[Read : Folic Acid- The Friend From Day One]

FAQ’s

1. When Can an Ultrasound Detect Spina Bifida?

The Myelomeningocele Spina Bifida can be detected in a second-trimester routine USG between 16 to 18 weeks of pregnancy.

2. What Are The Follow-up Treatments After Spina Bifida Surgery?

Depending on the position of the Spina Bifida and the disability it is causing, different follow-up treatments are done post-surgery. These can be bowel management, physical therapy, lower extremity bracing etc.

3. Does Having Folic Acid in First Trimester of Pregnancy Prevent Spina Bifida ?

According to NHS, taking folic acid-rich food and supplements can prevent up to 7 out of 10 neural tube defects like Spina Bifida.

Read Also: Congenital Ptosis in Babies – Causes, Symptoms, and Treatment