6. Neural tube Defect
Introduction
A neural tube defect is malformation of brain, spinal
cord , or both during embryonic development.
It happens in the first week of pregnancy even when she does
not that she is pregnant.
NTD is the most common defect.
In the United States approximately 30 out of 10,000 newborn
are born with NTD.
7. Etiology:
The causes of NTD are still unknown. The most
studied and likely cause involve interaction between:
Environmental factors
Nutrition
Genetic factors
Obese women
8. Classification of NTD
Classification of NTD are
Open NTD:
it is more common. It occur due to defect in the
brain and skull and exposed at birth.
Examples:anencephaly,encephaloceles,spina bifida.
Close NTD:
Rarest type of NTD are close NTD.it occur
when skin covered the spinal defect.
Examples:lipomyelomeningocele
10. Spina bifida occulta
In this type of neural tube defect, the meanings do not
herniated through the opening in the spinal canal. By
definition spina bifida means hidden split spine.
11. Meningocele
Outer part of vertebrae spilt.
Spinal cord usually normal.
Meninges damaged and displaced through opening.
12. Mylomeningocele:
Outer part of vertebrae spilt.
It involve herniation of meninges as well as spinal
cord.
Careful neurological examination is mandatory.
13. Signs and symptoms
Loss of bladder
Hips and legs become week
Legs paralyzed
Hair at sacral region
15. Anencephaly:
It is serious brain defect in which baby born without
parts of brain and skull.
It happens when the first part of neural tube defect
does not close all the way. This is often result in baby
being born without front part of brain.
Infants usually not survive and die within few hours or
days.
16. Encephalocele:
It is characterized by sac like protrusion of brain and
membranes.
Symptoms:
neurological problems
hydrocephalus
17. Diagnosis:
Tests are used to diagnose neural tube defects are
Ultrasound examination
Amniotic fluid alpha feto protein
Amniotic fluid acetyl cholinesterase
Often, these defects are apparent at birth, but
acute defects may not be diagnosed until much later in
life.
18. Medical management
Medical care
The new born with open NTD should be kept
warm and defect should be covered with sterile
dressing.
There is no cure for spina bifida as the damaged
nerve tissue cannot be repaired or its function cannot
be restored.
Surgical management:
Neurosurgical repair of defect is considered the
main stay of treatment for open spina bifida.
19. Prevention:
1. Pre conceptional folate supplementation
• Folate supplements taken one month before
conception and continued throughout the first
trimester can help support a
healthy pregnancy
Prevent neural tube defect.
• For this reason, all women of child bearing age
are capable of becoming pregnant should consume
400 microgram.
20. Cont’
2. Food fortification with addition of folate:
Grain product in the United states are fortified
with folate to help ensure an adequate intake.
Labels on fortified products may claim that an
adequate intake of folate has been shown to reduce the
risk of neural tube defect.
Fortification has improved the foliate status in women
of child bearing age and lowered the number of neural
tube defect that occur each year.
21. Treatment:
Treatment of NTD depend on severity of
complications.
No treatment is available for NTD.
Surgical management may improve survival and
functions of infants with spinal cord defect.
24. Fetal alcohol syndrome:
Introduction:
Fetal alcohol spectrum disorder are group of birth
defects that can happen when pregnant women drink
alcohol.
FAS is most severe type of disorder.
FAS is non genetic congenital disease.
People with FAS has many problems with their vision,
hearing, memory, abilities to learn and communicate.
25. Mechanism:
Human fetus is at triple risk of maternal alcohol
consumption. Mother who drink alcohol expose fetus
to alcohol in uterus.
Alcohol circulate to fetus in pregnant women. The
alcohol inhibit intrauterine growth.
There ,the alcohol crosses the blood brain barrier and
interfere with the ability of fetus to receive sufficient
oxygen.
26. Causes:
Women drinking alcohol during pregnancy is the cause of
FAS.
When pregnant women drinks alcohol it will pass to the
fetus. As the fetus has no fully developed liver so fetus does
not process the alcohol in same as adult so the alcohol
concentrated in fetus. So alcohol can interfere with the
normal function of fetus particularly brain and CNS.
It causes abnormal physical development by killing cells of
fetus.
It become the cause of shortage of oxygen and nutrient to
fetus.
27. Symptoms
Growth retardation
Delayed development of motor skills
Impaired language development
Facial features:
Eyes: small, drooping eye lid
Ears: small, low set
Nose: upturned, shortened
Mouth: thin upper lip, wide, cleft palate
29. Diagnosis:
No lap test that can prove that child has FAS.
To diagnose FAS, doctors seek for facial features. They
also try to find out whether the mother drink during
while pregnancy.
Symptoms cant be cured but early diagnosis can
improve child development and out look. The
following criteria should be met to diagnose FAS
Growth deficiency
FAS facial features
CNS damage
30. Treatment:
There are no medication that treat FAS.
Several medicines may address symptoms that
include:
Antidepressant treat problems with sadness
Antianxiety drugs treat anxiety
heart abnormalities may require surgery.
31. Count…
Counseling
Behavioral training may also help.
Children with FAS need academic help.
Executive function training may improve skills such as
self control.
Alternative treatment:
Movement treatment or exercises such as yoga etc it may
help in movement of skeleton.
32. Prevention:
Only way to prevent FAS to avoid drinking alcohol
during pregnancy.
Parental training
Concentrate on your child strength and talent
Accept your child limitations
Use concentrate language
