Document Detail


Prenatal course and outcome in 103 cases of fetal spina bifida: a single center experience.
MedLine Citation:
PMID:  20846060     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the prenatal course and functional outcome for fetuses with spina bifida according to the level of the spinal lesion at prenatal ultrasound examination. DESIGN: Retrospective, descriptive study. SETTING: Tertiary referral center, Germany. POPULATION: A total of 103 fetuses with spina bifida identified between 1993 and 2008. METHODS: The antenatal course and postnatal outcome for affected fetuses were reviewed. The relation of relevant outcome domains to the anatomical level was assessed using Fisher's exact test and the χ(2)-test. MAIN OUTCOME MEASURES: Level and type of spinal lesion, pregnancy outcome, psychomotor development, bladder and bowel function. RESULTS: Our cohort included a total of 31 live born infants, 68 terminated pregnancies, four intrauterine fetal deaths and five postnatal deaths. Four cases were excluded from follow-up. Twenty of the remaining 22 infants had normal or only slightly impaired mental development (91%). Thirteen children (59%) were able to walk, but nine (41%) needed wheelchairs or were paraplegic. The rate of poor motor outcome varied strongly in dependence on the level of the lesion (22.2% at lower lumbosacral levels to 80% at thoracic level). The majority of the affected children (16/22, 72.7%) suffered from impairment of bladder function. In 36% of cases (8/22) anal incontinence was documented. CONCLUSION: Spina bifida can result in a spectrum of disabilities that frequently lead to an impairment of bladder, bowel and motor function. The motor function depended on level of the lesion.
Authors:
Feriel Amari; Wiebe Junkers; David Hartge; Daniel Alexander Beyer; Roland Axt-Fliedner; Jan Weichert
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  89     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-17     Completed Date:  2010-09-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  1276-83     Citation Subset:  IM    
Affiliation:
Division of Prenatal Medicine, University Clinic of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. feriel.amari@uk-sh.de
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MeSH Terms
Descriptor/Qualifier:
Fecal Incontinence / etiology
Female
Humans
Infant
Infant, Newborn
Male
Nervous System Diseases / etiology
Outcome Assessment (Health Care)
Pregnancy
Pregnancy Outcome
Retrospective Studies
Spinal Dysraphism / complications*,  ultrasonography*
Ultrasonography, Prenatal
Urination Disorders / etiology

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