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Conditions We Treat

Spina Bifida and Myelomeningocele

Spina bifida is a type of neural tube defect, a problem with the spinal cord or the structures that cover it. The neural tube normally closes during the early weeks of development and can occur at any point along the spine. Spina bifida occurs because of the neural tube not closing completely during development, causing a hole in some of the bones of the spine.

What Is Spina Bifida, Meningocele or Myelomeningocele?

Spina bifida occurs because the neural tube does not close completely during an unborn baby’s development, causing a hole in some of the bones of the spine (vertebrae). This may result in spinal cord and nerve damage, which may cause mild to severe disabilities. The exact cause of spina bifida is unknown. There are three major types:

  • Spina bifida occulta is the mildest form of spina bifida.
  • Meningocele forms when the bones of the spine (vertebrae) do not close completely, and the meninges protrude in a sac through the hole that is formed.
  • Myelomeningocele is the most severe form of spina bifida. The spinal cord and its coverings are exposed.

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How Are Spina Bifida, Meningocele or Myelomeningocele Diagnosed?

These conditions are found during prenatal testing (testing of mother and unborn baby during pregnancy). If your doctor suspects a problem, additional tests may be ordered, such as:

  • Alpha-fetoprotein testing of mother’s blood: This protein (AFP) may be found in your blood if you are pregnant with a baby that has a myelomeningocele.
  • Ultrasound: A type of imaging that uses sound waves to see inside the body.
  • Amniocentesis: A small sample of the amniotic fluid that surrounds the baby in the womb is taken and tested for DNA problems. This test is usually done in the middle of the second trimester.
  • Fetal MRI (magnetic resonance imaging): This type of imaging gives more detailed pictures of your baby’s organs that may not have been seen on ultrasound.

How Are Spina Bifida, Meningocele or Myelomeningocele Treated During Pregnancy?

If a test finds you are carrying a baby with spina bifida, meningocele or myelomeningocele, you will continue to receive care from your obstetrician (OB/GYN). Your OB/GYN may also refer you to the Fetal Center at Nationwide Children’s, where you will meet with a team including maternal-fetal medicine subspecialists, neonatologists (doctors who specialize in treating newborns), pediatric and fetal surgeons (doctors who perform surgery), and nurses to learn more about your baby’s care. They may suggest treatments such as:

  • Post-natal surgery: Mild forms of spina bifida can be safely treated after birth. Treatment after birth is also available for severe forms of spina bifida.
  • Fetal surgery (intrauterine surgery): Studies have shown that some severe forms of spina bifida may benefit from treatment before birth. The exposed fetal spinal cord is surgically covered. The surgery involves opening the mother’s abdomen and the uterus to gain access to the fetus (open fetal surgery) or opening the abdomen to put small instruments through an intact uterus to gain access to the fetus (fetoscopic spina bifida repair). When fetal intervention is required, procedures are performed at Nationwide Children’s in a specially equipped operating room. After the procedure, patients are transported to our fetal care unit with a dedicated team of experts for both mom and baby.

What Is My Baby’s Outcome (Prognosis)?

Every child is unique. Children with spina bifida are at risk for developing difficulty with bowel and bladder function as well as ability to stand and/or walk. Fluid may also collect within the drain and need a small tube (shunt) to drain the fluid into the abdomen. All these children need assessment and treatment in the newborn period and continued monitoring over the course of their lives (into adulthood) through our multidisciplinary spina bifida clinic where they meet with medical and surgical specialists to monitor their care and development. After fetal surgical repair, your doctor will help you figure out your child’s care plan.

Speak With Our Team

Our team is here to help as soon as you learn your baby may have a fetal concern or diagnosis. And a physician referral is not required. Our expert team evaluates and treats nearly every fetal complication, from the most common to the most complex conditions. With access to advanced diagnostic imaging, ultrasounds and fetal MRIs, you'll find the answers, and the treatment, here.

Looking for a second opinion? The Fetal Center team can help. Our team of specialists work together to provide comprehensive feedback on your diagnosis and treatment plan through either an in-person visit or via an online written report. Our team can help you decide which is right for you.

Complete the form below or call (614) 869-4609 and the Fetal Center team will be in touch with you.

 

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