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WHAT IS SB :

Spina Bifidaare a Latin words which literally means “Split Spine”. During the first month after conception, the embryo develops a primitive tissue structure known as the neural tube.This structure gradually develops into bones, nerves, and tissue. These eventually form the nervous system, the spinal column, and the spine, a ridge of bone that protects and surrounds the nerves.In spina bifida, the neural tube and spinal column do not develop properly. The spine does not close fully, and the spinal column remains exposed along several vertebrae.A sac forms on the fetus' back as the membranes and spinal cord push out. The sac may be covered with meninges, or membranes.Out of 1000 babies born in India, spina bifida affects between 4-8 of them.

TYPES :
There are four main types of spina bifida:

1. Occulta : This is the mildest form. Most patients have no neurological signs or symptoms. There may be a small birthmark, dimple or tuft of hair on the skin where the spinal defect is. The person may never know they have spina bifida unless a test for another condition reveals it by chance
2. Closed neural tube defects : In this version, there can be a variety of potential defects in the spinal cord's fat, bone, or meninges. In many cases, there are no symptoms; however, in some, there is partial paralysis and bowel and Urinary Incontinence.
3. Meningocele : The spinal cord develops normally, but the meninges, or protective membranes around the spinal cord, push through the opening in the vertebrae. The membranes are surgically removed, usually with little or no damage to nerve pathways.
4. Myelomeningocele : Myelomeningocele is the most severe form of spina bifida. In this condition, the spinal cord is exposed, causing partial or complete paralysis of the body below the opening.

CAUSES :
It is unclear exactly what causes spina bifida. Scientists say it is most likelydue to a combination of inherited, or genetic, environmental and nutritional factors.

1. Folic acid : Spina bifida is more likely if a mother does not have enough folic acid during the pregnancy, although the reason is unclear. Most cases of Spina Bifida can be prevented by an adequate intake of Folic acid by the mother-to-be in the Periconceptional period (before and during the pregnancy). Some natural foods such as spinach, orange, peas, green beans etc. are rich source of folates.
2. Plant proteins, iron, magnesium, and niacin : A low intake of these nutrients before conception may be associated with an increased risk of neural tube defects by two to five times.
5. Diabetes : A woman who has diabetes is more likely to have a baby with spina bifida, than one who does not.
6. Obesity : A woman whose body mass index (BMI) is 30 or above has a higher risk of having a baby with spina bifida.

PREVENTION & DETECTION :
  1. It is important that a women start taking folic acid much before the pregnancy (at least 6-8 weeks prior to the conception. Because the development of baby’s spinal cord occurs much early in gestation.
  2. Approximately 90% cases of Spina Bifida are detected with an ultra sound scan before 18 weeks of pregnancy.
  3. Alpha Fetoprotein Test is a simple blood test which is performed in 15-20 weeks of pregnancy to measure the level of Alpha Fetoprotein, a protein released by Baby’s liver. Abnormal results may indicate a spinal cord defect.
  4. If Spina Bifida is mild, it may not be detected until the baby is born. Imaging tests such as MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) can be used to detect any abnormalities in the spine.