Co-morbidities Associated With Early Mortality in Adults With Spina Bifida

Dicianno, Brad E.; Sherman, A.; Roehmer, Christian; Zigler, Christina K.

doi:10.1097/phm.0000000000000964

Cited by 36 publications

(45 citation statements)

References 17 publications

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“…Symptomatic CM-II patients will suffer from swallowing problems, airwaybreathing difficulties, or even apnea and may require multiple surgical interventions, including surgical decompression. 17 In patients with symptomatic CM-II, the primary goal is to reduce intracranial pressure by CSF diversion and surgical decompression. Young patients with CM-II also need physiotherapy in terms of bladder function, respiratory-related disorders, and digestive-related disorders.…”

Section: Discussionmentioning

confidence: 99%

Clinical Manifestation and Initial Management of Newborn with Spina Bifida Aperta: a case report.

Sandinirwan

Hadisaputra

2021

J Res Clin Med

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Spina bifida is a birth defect that occurs due to the disruption of the formation of the neural tube with an incidence of 1–10 cases per 1000 live births. Spina bifida can appear as an occulta or aperta type, and the latter consists of meningocele, myelomeningocele, and myeloschisis. We reported a case of a term male newborn who was presented with lethargic, bradypnea, suction reflex abnormalities, and paralysis of lower extremities. A defect was found in the spine in the thoracolumbar region showed a placode with no meningeal and skin covering, suggestive of a myeloshisis. The patient was treated in the neonatal intensive care unit, was placed on non-invasive ventilation with successful weaning, parenteral nutrition, systemic antibiotics regimen, and wound care. The patient was consulted with a neurosurgeon and was subjected to an ultrasound examination of the head that led to hydrocephalus. After experienced clinical improvement and oral tolerance, the patient was allowed for discharged and scheduled for surgery.

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Section: Discussionmentioning

confidence: 99%

Clinical Manifestation and Initial Management of Newborn with Spina Bifida Aperta: a case report.

Sandinirwan

Hadisaputra

2021

J Res Clin Med

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“…Children with lower level lesions are more likely to walk than those with higher level lesions. Moreover, the level and the extent of the defect are usually considered among the major predictors of the ability to walk, with quadriplegia often arising from cervical lesions and paraplegia mostly associated with thoracic and lumbosacral lesions 8,38‐40 …”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the level and the extent of the defect are usually considered among the major predictors of the ability to walk, with quadriplegia often arising from cervical lesions and paraplegia mostly associated with thoracic and lumbosacral lesions. 8,[38][39][40] In view of this association, prenatal counseling of parents whose pregnancy is complicated by fetal spina bifida should explore the potential limitations of ultrasound in identifying the level of the lesion. level.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of prenatal ultrasound in identifying the level of the lesion in fetuses with open spina bifida: A systematic review and meta‐analysis

Mascio

Greco

Rizzo

et al. 2020

Acta Obstet Gynecol Scand

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Introduction The role of prenatal ultrasound in correctly identifying the level of the lesion in fetuses with open spina bifida has yet to be determined. The primary aim of this systematic review was to report the diagnostic accuracy of ultrasound in determining the level of the lesion in fetuses with open spina bifida. The secondary aim was to elucidate whether prenatal magnetic resonance imaging (MRI) improves the diagnostic performance of prenatal imaging in correctly identifying the level of the lesion. Material and methods Inclusion criteria were studies reporting the agreement between ultrasound, MRI and postnatal or postmortem assessment of fetuses with spina bifida. Agreement was defined as: complete (when the upper level of the lesion detected prenatally was the same recorded at postnatal or postmortem evaluation), within one (when the upper level of the lesion recorded prenatally was within one vertebral body higher or lower than that reported postnatally) and within two vertebral bodies (when the upper level of the lesion recorded prenatally was within two vertebral bodies higher or lower than that reported postnatally or postmortem evaluation). Meta‐analyses of proportions were used to combine data. Results Fourteen studies (655 fetuses) were included. Ultrasound was able to identify the correct level of the lesion in 40.9% (95% confidence interval [CI] 26.9‐55.6) of cases. The upper level of the lesion recorded on ultrasound was within one vertebral body in 76.2% (95% CI 65.0‐85.9) of cases and within two segments in 92.4% (95% CI 84.3‐97.7). Fetal MRI detected the exact level of the lesion in 42.5% (95% CI 35.9‐45.2) of cases; the level of the lesion recorded on MRI was higher in 26.4% (95% CI 20.0‐33.3) of cases and lower in 32.4% (95% CI 25.5‐39.7) than that confirmed postnatally. The upper level of the lesion recorded on MRI was within one vertebral body in 76.2% (95% CI 65.9‐85.2) of cases and within two segments in 94.2% (95% CI 90.2‐97.2). Conclusions Both ultrasound and MRI have a moderate diagnostic accuracy in identify the upper level of the lesion in fetuses with open spina bifida.

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“…Individuals with SB experience increased morbidity and mortality as well as increased acute care utilization compared to those without SB [14,23,39,45,46]. Urinary tract infections, device complications such as shunt malfunction, pressure ulcers and soft tissue infections, as well as pneumonia are often reasons for acute care utilization for all age groups and therefore are important diagnoses to target for preventive care interventions [23,24,39,47].…”

Section: Discussionmentioning

confidence: 99%

Health promotion and preventive health care service guidelines for the care of people with spina bifida

Fremion

Kanter

Turk

2020

PRM

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Individuals with Spina Bifida (SB) have unique lifelong medical and social needs. Thus, when considering how to promote health and offer preventive care, providers must consider how to adapt general healthcare screening and counseling recommendations to their patients’ physical and cognitive impairments along with discerning how to monitor secondary or chronic conditions common to the population. This article provides an update on the health promotion and preventive health care guidelines developed as part of the Spina Bifida Association’s fourth edition of the Guidelines for the Care of People with Spina Bifida. The guidelines highlight accommodations needed to promote general preventive health, common secondary/chronic conditions that require monitoring such as obesity, metabolic syndrome, hypertension, musculoskeletal pain, and considerations for preventing acute care utilization for the SB population throughout the lifespan. Further research is needed to understand the effectiveness of preventive care interventions in promoting positive health outcomes and mitigating potentially preventable acute care utilization.

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Co-morbidities Associated With Early Mortality in Adults With Spina Bifida

Cited by 36 publications

References 17 publications

Clinical Manifestation and Initial Management of Newborn with Spina Bifida Aperta: a case report.

Clinical Manifestation and Initial Management of Newborn with Spina Bifida Aperta: a case report.

Diagnostic accuracy of prenatal ultrasound in identifying the level of the lesion in fetuses with open spina bifida: A systematic review and meta‐analysis

Health promotion and preventive health care service guidelines for the care of people with spina bifida

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