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What is spina bifida?
Spina bifida is a birth defect that affects the development of a baby’s spine during the mother’s pregnancy. The baby’s spine does not close completely, causing damage to the baby’s spinal cord and nerves. Pregnancy screening, spinal surgery for the baby after birth, and other support for more severe cases offers a positive outlook for most people diagnosed with spina bifida.
There are 3 types of spina bifida:
Spina bifida occulta
- The least serious form of the birth defect.
- The opening in the spine is usually small. The spinal cord and nerves are healthy.
- Diagnosed at an older age if the person’s mother didn’t have prenatal testing or there were no physical signs at birth.
- It’s usually diagnosed following a back X-ray for another health problem.
- No physical or intellectual disabilities after diagnosis.
- An opening in the spine that allows spinal fluid to leak and damages the spinal cord membranes.
- No major nerve damage in most cases.
- Minor physical disabilities are possible, but the risk is low.
- May have problems controlling your bowel and bladder.
- The most serious form of spina bifida.
- The spinal cord and nerves are moderately or severely damaged through the opening in the spine. Spinal fluid leaks from the baby’s back.
- Paralysis in the lower part of the body is possible, which also affects a person’s bowel and bladder control.
Doctors consider the size and location of the opening in the spine, as well as the type to determine how severe it is.
Symptoms of spina bifida
A person diagnosed with spina bifida occulta may never have symptoms. People diagnosed with the meningocele or myelmeningocele types may have symptoms that are present in pregnancy screenings or are visible just after the baby’s birth.
Pregnancy screening symptoms:
- Abnormal levels of protein in the mother’s blood. This is measured with a test called an alpha-fetoprotein (AFP) test. It checks the amount of protein that is produced by the baby and passed on to the mother.
- Abnormal levels of protein in the amniotic fluid that surrounds the baby during pregnancy. This is measured through a procedure called amniocentesis.
- Abnormal-looking spine during a pregnancy ultrasound. An ultrasound is an imaging scan taken of the baby during pregnancy.
Your family doctor may recommend a pregnancy screening if:
- You have another child with spina bifida.
- You have a family history of spina bifida.
- You have not been taking folic acid during your pregnancy.
- You have certain health conditions (diabetes, obesity).
- You take certain medicine for seizures or depression.
Symptoms at birth:
- Hydrocephalus (fluid on the brain that makes the baby’s head look unusually large or causes the soft spot on the baby’s head to bulge).
- Muscle weakness in the baby’s feet, hips, and legs.
- A dimple or patch of hair in a certain spot on the baby’s back. This may raise suspicion. However, muscle weakness and hydrocephalus provide better clues to the possibility of spina bifida.
What causes spina bifida?
Spina bifida occurs during pregnancy, as a baby is developing in the womb. The baby’s spine does not close completely.
How is spina bifida diagnosed?
If your doctor suspects your baby has spina bifida at birth, he or she may recommend an X-ray, magnetic resonance imaging (MRI), or computed tomography (CT) scan.
Can spina bifida be prevented or avoided?
The cause of spina bifida is unknown. However, studies show that the vitamin folic acid, present in women before and during pregnancy, can reduce the risk of spina bifida. Eating foods high in folic acid (dark, leafy greens, beans, peas and lentils, seeds and nuts are just some of the foods) can help. Women should take a folic acid supplement during their childbearing years because some pregnancies are not planned. For this reason, doctors recommend that any woman of childbearing age take 0.4 milligrams (mg) of folic acid every day to reduce the risk of spina bifida. Some women may be required to take a larger dose if they have been taking a particular medicine for epilepsy or depression, or if they have a family history of spina bifida.
Spina bifida treatment
Although there is no medicine or cure for spina bifida, surgery after birth can help. Some babies can and should have surgery while still in their mother’s womb, depending upon the type and severity of their condition. The majority of babies, however, will require surgery as early as 1 to 2 days after birth. Some may have repeated surgeries over the years. Surgery usually involves a team of specialists.
If surgery does not improve your baby’s diagnosis, your doctor may refer you to a physical therapist who can help your child increase his or her strength and balance. A physical therapist can also teach your child how to use equipment to help with moving independently (such as leg braces, a walker, crutches, or a wheel chair).
In more severe cases that affect your child’s learning and academic performance, your family doctor may also refer you to special education resources within your local school district for support.
Living with spina bifida
If your baby is born with spina bifida, his or her health outlook depends on the location, size, and the type of his or her spina bifida. A number of mild and severe complications are possible, including:
- nerve sensation
- skin irritation
- latex allergy (a natural rubber)
- stomach disorders
- learning and intellectual disabilities
- depression (in the teen and adult years)
- hydrocephalus (fluid around the brain)
If surgery hasn’t improved your child’s spina bifida, you can help your child manage walking complications with the use of crutches, a walker, or wheelchair. For intellectual disabilities that affect your child’s school performance (reading, writing, math, etc.), educational support is available from your local school district. If the intellectual disability is severe, there are a number of government and private social service providers to help your child live an inclusive life in his or her community as an adult.
Questions to ask your doctor
- When should I start taking folic acid in my pregnancy?
- Will I get enough folic acid through foods only?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.