How are Neural Tube Defects diagnosed and treated? - Dr Tanushri Mukherjee

Описание: We can diagnose neural tube defect really fast. Early in the second trimester, we do the maternal serum alfafetoprotein level in the routine triple test . If the maternal alfafetoprotein levels are much higher say 2 to 2.5 times higher then the baby affected with neural tube defect are very high. That we can diagnose and subsequently confirm with amniotic fluid test also. In amniotic fluid, we can test by the acetylcoline esterase. That also gives us an idea about whether the baby has neural tube defects or no. The second diagnosis from the further ultrasonography. If we do a detailed ultrasonography, in the second trimester, almost 90 to 95% of the open neural tube defects can be diagnosed on the sonography. The treatment of the neural tube defect starts from the prevention of neural tube defects. As we know that folic acid is the magic bullet, if we start the folic acid in the mothers, we can prevent the mothers from having a neural tube defect affected pregnancy and once the neural tube defect happens, there is no cure for that baby. That we can do is we can treat the baby and we can prevent the complications of neural tube defect. Suppose if the baby is born with a spina bifida defect, then we have to take the baby immediately for the surgery to close the defect. Otherwise it can get infected and that can lead to their morbidity. If the baby is having some tethered cord. There the cord is attached to the lower part of the spinal cord and as the babies grow, the nerve fibers get stretched and the baby can get more and more symptoms with that. Here we have to surgically release the cord so that the baby can get rid of the symptoms. Other common complications of neural tube defect is a hydrocephalus. Here there is a collection of the CSF or the brain fluid surrounding the parenchyma and to treat hydrocephalus, most of the times you have to put a shunt in the babies head and, it is just nothing but a small tubes in the babies head that we have to put a shunt in the babies head and that drains the surrounding fluid. Another most common thing that we see in these type of babies is a there is a lot of difficulty in the ambulation and the mobility. So they need lots of support in the form of braces, crutches, wheelchairs, lot of physiotherapy , family support for these babies for the actual morbidity. Last but not the least, we now that these babies have some urinary retention and urinary tract infection. So there are bladder surgeries that we can do in these babies to help the bay to make them continent as well as they need multiple catheterization to present them socially acceptable and many of the times we have to give them antibiotics so that urinary tract infection can be prevented and kidney damage can be prevented in an earlier stage.