SPINA BIFIDA;

THE BASIC AND CLINICAL REVIEW

Abstract

Spina Bifida (SB) is a neural tube defect (NTD) due defect in neural tube,
characterized by incomplete closure of spinal column. Occurrence of SB varies in different
countries. In developed countries, it is about 0.4 per 1000 births, in US 0.7 per 1000 births and in
Asia 1.9 per 1000 births. SB mostly occurs during first trimester of pregnancy. Variants of SB are
Spina bifida Occulata, Spina bifida Cystica [meningocele and myelomeningocele], Spina bifida
Manifesta and Spina bifida Aperta. Among these myelomeningocele is the most common type.
Causing agents of SB may be genetic, non-genetic or environmental factors. Non-genetic factors
involve anti-convulsant drugs, anti-epileptic drugs, maternal obesity, maternal diabetes and
poor nutritional status (folate and vitamin B12 deficiency). Environmental factors are pesticides,
nitrated compounds and air pollution. Common manifestations are brain malformations (Arnold
Chiari II malformation and hydrocephalus), spinal cord abnormalities, latex allergy, breathing
problems, urological abnormalities and cardio-metabolic dysfunction. Diagnostic techniques
for Spina bifida are ultrasound screening, Magnetic Resonance Imagining (MRI), amniocentesis
and maternal serum alpha-fetoprotein. To prevent the risk of Spina bifida, it is recommended for
the mother to use 0.4mg of folic acid per day or in mothers affected with multiple pregnancies
recommended dose of folic acid is 4mg per day.