Neural Tube Defects

Cause

Folic Acid Deficiency (B9)

Anencephaly

Without skull

Spina Bifida

failure to fuse (spine)

Two types of Spina Bifida

Occulta and Cystica

Two types of Cystica

Meningocele and Myelomeningocele

Occulta

Dimpling

Tufts of hair

Foot weakness - spinal cord compression

Cystica below L2

Flaccidity - loss of muscle tone

Partial Paralysis

Urine Dribbling

Rectal Prolapse

Below L3 (end of sacrum)

No signs and symptoms

Diagnostic

Amniocentesis and Transillumination

Purpose of Transillumination

To detect the presence of the spinal cord in the sac

Short-term complication

Meningitis

Long-term complication

Hydrocephalus

What should be done before an amniocentesis?

UTZ

What is the purpose of UTZ?

To locate the fetus, placenta, and amniotic fluid pockets

What should be done after an amniocentesis?

Check the fetal HR

When is amniocentesis done?

First Trimester

What is the purpose of amniocentesis during the first trimester?

To detect AFP

What does it mean if alpha-fetoprotein (AFP) is high in the first trimester?

NTD

What does it mean if alpha-fetoprotein (AFP) is low in the second trimester?

Trisomy 21

What is the normal lecithin-sphingomyelin (L/S) ratio?

2:1

Purpose of amniocentesis during the third trimester

to check for fetal lung maturity

Can you use diapers?

No

What is the correct position?

Prone

What type of foam should be used?

Soft

What should you closely inspect the sac for?

leaks or irritation

What should be applied to the sac?

A sterile, moist, non-adherent dressing to prevent drying

Should you cleanse it carefully if it becomes soiled?

Yes

Myelomeningocele

sac, csf, spinal cord

Meningocele

sac, csf