Prenatal myelomeningocele treatment and diagnosis

755 views
431 views

Published on

Learn more about myelomeningocele and spina bifida at http://www.spinabifida.net

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
755
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
11
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Prenatal myelomeningocele treatment and diagnosis

  1. 1. Prenatal MyelomeningoceleTreatment and DiagnosisLearn more aboutMyelomeningocele and Spina Bifidaat http://www.spinabifida.net
  2. 2. Terminology• Myelomeningocele- Results from failure of proper neural tube closureduring primary neurulation.- Leaves a flat plate of neural tissue called theneural placode.- As a result, the overlying mesodermal andectodermal elements fail to form and an openspinal defect is produced.- Associated with a Chiari II malformation.
  3. 3. Prenatal diagnosis• Maternal Serum Alpha Fetoprotein- Initial screen for NTDs.- In amniotic fluid, the AFP conc. is 100-fold less than in fetalCSF.- Sampling at GA 16-18 wks- MSAFP level of 1.5 multiples of the median  risk of 1 in2317 for an open NTD.- MSAFP level of 2.5 multiples of the median  risk of 1 in98 for an open NTD.- Diagnostic accuracy 60-70%- If risk > 1 in 500  further U/S is recommended- False positive of MSAFP levels : incorrect estimated GA,multiple pregnancy, fetal demise
  4. 4. Prenatal diagnosis• Ultrasonography- The sensitivity is nearly 100% in prenatalscreening for NTDs.- Visualize two cranial abnormalities :- characteristic of hydrocephalus  “lemon sign”scolloping of the frontal bones on a biparietalview- Chiari II malformation associated with spinabifida  “banana sign” abnormally shapedmidbrain, elongated cerebellum, obliteration ofthe cisterna magna
  5. 5. Prenatal diagnosis• Magnetic Resonance Imaging- Prenatal MRI is increasingly being used toexamine fetal neurological anomalies.- Provides greater resolution than U/S.
  6. 6. Prenatal diagnosis• Amniocentesis- The amniotic AChE level is used to increasedthe diagnostic accuracy of the amniotic AFPlevel.- In NTD : neural AChE from CSF leaks into theamniotic fluid.- Accuracy of 99%, false positive of 0.34%
  7. 7. Questions?• For more educational resources please visithttp://www.spinabifida.net
  8. 8. Questions?• For more educational resources please visithttp://www.spinabifida.net

×