Abstract
Objectives
To find out the relative prevalence of fetal neural tube defect (NTD) and its outcome in terms of survival at birth and beyond 2 years of age.
Methods
A 10-year prospective (2008–2018) observational study was performed, which included all prenatally detected fetal NTD. Two-year follow-up was done in cases of pregnancies resulting in live birth, in terms of their survival, physical morbidity and developmental delay.
Results
NTD was seen in 401/648 (62%) cases among the central nervous system malformations. More than half of the cases (54.1%) presented after 20 weeks of gestation, and 42.8% of the mothers were primiparous. Spina bifida was seen in 206 cases, anencephaly in 144, encephalocele in 43, whereas iniencephaly was seen in only eight cases. Associated anomalies were present in 51.2%. Only 19.0% cases were live-born, and merely 11% were alive beyond 2 years of age. Among types of spina bifida, lumbosacral meningomyocele was the most common (41.6%), whereas thoracic was the rarest (8.7%). After 2 years, physical disability was observed in more than half of the cases who survived.
Conclusions
NTD is one of the commonest malformations with high mortality, and the physical and mental sub-normality is high among those who survive.
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References
Hans JTD, Martin L, Akira H. Clinical neuroembryology: development and developmental disorders of the human central nervous system. 2nd ed. Heidelberg: Springer; 2014.
Greene ND, Stanier P, Copp AJ. Genetics of human neural tube defects. Hum Mol Genet. 2009;18:R113–29.
Hunter A. Brain and spinal cord. Oxford Monogr Med Genet. 2006;52:715.
Mahapatra A. Spinal dysraphism controversies: AIIMS experiences and contribution. Indian J Neurosurg. 2012;1:4–8.
Busby A, Abramsky L, Dolk H, et al. Preventing neural tube defects in Europe: a missed opportunity. Reprod Toxicol. 2005;20(3):393–402.
Lorber J. Spina bifida cystica. Results of treatment of 270 consecutive cases with criteria for selection for the future. Arch Dis Child. 1972;47(256):854–73.
Kandasamy V, Subramanian M, Rajilarajendran H, et al. A study on the incidence of neural tube defects in a tertiary care hospital over a period of five years. J Clin Diagn Res JCDR. 2015;9(7):QC01–4.
Adeleye AO, Olowookere KG. Central nervous system congenital anomalies: a prospective neurosurgical observational study from Nigeria. Congenit Anom (Kyoto). 2009;49(4):258–61.
Kumar R, Singhal N. Outcome of meningomyelocele/lipomeningomyelocele in children of northern India. Pediatr Neurosurg. 2007;43(1):7–14.
Netto JM, Bastos AN, Figueiredo AA, et al. Spinal dysraphism: a neurosurgical review for the urologist. Rev Urol. 2009;11:71–81.
Thompson DN. Postnatal management and outcome for neural tube defects including spina bifida and encephalocoeles. Prenat Diagn. 2009;29(4):412–9.
Kuo BJ, Vissoci JR, Egger JR, et al. Perioperative outcomes for pediatric neurosurgical procedures: analysis of the National Surgical Quality Improvement Program-Pediatrics. J Neurosurg Pediatr. 2017;19(3):361–71.
Shin M, Kucik JE, Siffel C, et al. Improved survival among children with spina bifida in the United States. J Pediatr. 2012;161(6):1132–7.
Hunt GM. Open spina bifida: outcome for a complete cohort treated unselectively and followed into adulthood. Dev Med Child Neurol. 1990;32:108–18.
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Manisha Kumar is a Professor in Department of Obstetrics and Gynecology at Lady Hardinge Medical College, New Delhi, India. Aayushi Hasija is a Senior Resident in Department of Obstetrics and Gynecology at Lady Hardinge Medical College, New Delhi, India. Nikita Garg is an Intern in Department of Obstetrics and Gynecology at Lady Hardinge Medical College, New Delhi, India. Ramya Mishra is a Resident in Department of Obstetrics and Gynecology at Lady Hardinge Medical College, New Delhi, India. S. C. Roy Chaudhary is a Director Professor and Head, Pediatric Surgery at KSCH, New Delhi, India.
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Kumar, M., Hasija, A., Garg, N. et al. Relative Prevalence and Outcome of Fetal Neural Tube Defect in a Developing Country. J Obstet Gynecol India 70, 195–201 (2020). https://doi.org/10.1007/s13224-020-01311-x
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DOI: https://doi.org/10.1007/s13224-020-01311-x