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Neural Tube Defects - Paediatrics - Lecture Slides, Slides of Pediatrics

Neural Tube Defects, Neonatal Period, Termination of Pregnancy, Spina Bifida, Tube Defects Position, Tube Defects Position, Consanguinity, Folic Acid Prevention, Maternal Bloodstream. A major difference between pediatrics and adult medicine is that children are minors and, in most jurisdictions, cannot make decisions for themselves. This is one of lecture on Pediatrics. Main points of this lecture given above.

Typology: Slides

2011/2012

Uploaded on 12/23/2012

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Neural tube defects in the
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Neural tube defects in the

neonatal period

Incidence

Authors Data published

Defects Termination of pregnancy

Incidence/Birth

Waleed Murshid (KSA) [ 1]

2000 Spina bifida - 1.09/

Amira Masri (Jordan) [2]

2006 NTD - 1.1/

( Syria ) [3]


A.K.Njamnshi (Cameroon) [4]

2008 NTD - 1.99/

Louis duplessis (Australia )[5]

2008 NTD 79% 1.3/

Including termination of pregnancy ( 0. 26) CDC (USA)[6] (^2007) Spina bifida

  • 0.17/ ( 2005)

Neural tube defects position

Spina bifida cystica

Encephalocele Anencephaly

A.K.Njamnshi

Cameroon

2008 (98cases) [4]

71% 21.1%^ 5.4%

Hamza Ali

Children hospital

Damascus 2008 ( 170 cases) [3]

155 cases 15 cases

Consanguinity

consanguinity Percentage

Waleed Murshid (KSA) [ 1] 89%

Hamza Ali

Children hospital

Damascus 2008

( 170 cases) [3]

67 cases /170 39.4%

Folic acid prevention

Periconceptional folic Acid prevention

During pregnancy Folic Acid prevention

A.K.Njamnshi

Cameroon

2008 (98cases) [4]

Hamza Ali

Children hospital

Damascus 2008 ( 170 cases) [3]

Screening

  • AFP (In the amniotic fluid or maternal bloodstream )
  • Detection of a neural tube defect with fetal Ultrasonography

risk factors include :

  • previous pregnancies have been affected with NTDs
  • some anticonvulsants such as carbamazepine and sodium valproate
  • pregnancies complicated by diabetes at conception

Clinical signs

Total Paralysis

Of lower limb Percentage

Amira Masri (Jordan) [2}

Hamza Ali

Children hospital

Damascus 2008

( 170 cases) [3]

Complications

Leakage of

CSF

Proved

Meningitis

CNS

Abscess

Hamza Ali

Children hospital

Damascus 2008

( 170 cases) [3]

Recommendation

Refer patients as early as possible to special centers which

cover different areas in a given region.

  • Periconceptional folate supplementation has been shown to

reduce the incidence of NTDs, with data suggesting that a daily

intake of 0.4mg of folic acid reduces the risk of 1st neural tube

defects by up to 70% and Women at high risk require 5mg

daily.

  • Screening and Detection

1. Alpha feto protein (AFP) from amniotic fluid is very reliable

except when the defect is closed.

2. Maternal serum AFP is less reliable, detecting between 50-90%

of open anomalies, but is falsely positive in 5%.

3. Ultrasonography: Diagnosis often made at 16-18 week

Very reliable when done by experienced ultrasonographer

4. Termination of pregnancy still a hard fact to deal with