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Preventing spina bifida in children

Mariam had given birth at home and observed a defect at her son’s back not long after his birth. His spine was curved with an…

Mariam had given birth at home and observed a defect at her son’s back not long after his birth. His spine was curved with an open space accompanied by breathing problems, vomiting, urinary problems as well as occasional seizures.

He was later diagnosed with a type of spinal bifida at a hospital.

Spina bifida is a neural tube birth defect that occurs when the spine and spinal cord don’t form properly. The neural tube is the structure in a developing embryo that later forms the baby’s brain, spinal cord and the tissues around them.

Dr Victor Alade, an obstetrician and gynaecologist at the Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, said spina bifida is a condition in which there is deformity along the spine.

He said the condition is both a genetic and an environmental one.

“It is genetic because we have found it in a certain group of people and that means it is restricted to them. Each muscle or spine is being controlled by a gene. So if there is a mutation or problem with the gene, it can cause a situation whereby the spine will not be properly arranged. If there is a space between we call it bifida,” he said.

He said the condition occurs when the mother didn’t take folic acid and sometimes when there is a genetic disposition to it.

He said, “probably, there is somebody in there that had it before you. Like where there is a family history and nothing was done about it and the mother now doesn’t take folic acid. That makes it two factors that can make the baby develop such defect. However, it can be also picked during pregnancy.

The expert said the different types of spina bifida are spina bifida occulta and myelomeningocele and the very rare type meningocele

Spina bifida occulta, which is the most common and mild type, involves small separation or gaps in one or more of the bones of the spine. Children with spina bifida occulta typically don’t have any symptoms or complications.

Myelomeningocele is the severe type of the condition and the spinal canal is open along several vertebrae in the lower or middle back. Experts say this type exposes the baby to infection, paralysis and loss of bladder control because the membranes and spinal nerves push through this opening at birth, forming a sac on the baby’s back, typically exposing tissues and nerves.

He said women should go for preconception care because when people don’t have adequate folic acid vitamins, the spine will not be well-formed.

Dr Alade said if the mothers of children born with spinal bifida had attended ante-natal, the condition could have been picked with a specialised scan during pregnancy.

“Especially four-dimensional scan. In developed countries, the baby is diagnosed inside the womb, and they can operate the baby while inside the mother or bring the baby out of the womb and return it after operation back inside the womb. 

“The baby will then be born without the problem. They do it a lot in other countries,” he said.

He said in Nigeria some women don’t attend ante-natal care, while some deliver at home.

He said surgery is the usual treatment.

The obstetrician said preconception care is very important in preventing spina bifida and that women can be given folic acid for three months before they think of getting pregnant.

 “Preconception care is very important; women should go for preconception care before they think of getting pregnant. When they get pregnant for the second month then they go for a scan. From the fourth month, women should start ante-natal care at least if there is an issue they will be attended to regularly,” he advised.

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