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NEURAL TUBE DEFECTS

NEURAL TUBE DEFECTS. By: Kristen Willey Data Abstractor/Research Analyst Utah Birth Defect Network Health Promotion Major. OBJECTIVES. What is Folic Acid? Who is it for? Why do we need it? Purpose in Fetus? Studies Where does Folic Acid come from? What is a Neural Tube Defect?

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NEURAL TUBE DEFECTS

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  1. NEURAL TUBE DEFECTS By: Kristen Willey Data Abstractor/Research Analyst Utah Birth Defect Network Health Promotion Major

  2. OBJECTIVES • What is Folic Acid? • Who is it for? • Why do we need it? • Purpose in Fetus? • Studies • Where does Folic Acid come from? • What is a Neural Tube Defect? • Pictures • Causes of NTDs • How is it fixed? • Life After Surgery • Conclusion • Questions/Comments

  3. Form of water soluble vitamin B9 Occurs naturally in food Can be taken as a supplement What is Folic Acid?

  4. WHO TAKES FOLIC ACID? • Women of child bearing ages • Those who plan on becoming pregnant three months prior to planned conception • Pregnant women for the first three months of pregnancy • Technically, all women should take it

  5. Why take Folic Acid? • Prevents and lessens risk of birth defects called Neural Tube Defects • Builds red and white blood cells in maternal and fetal blood • Builds maternal platelets • Facilitate normal growth of a fetus • Recommended dose: 400-600 mcg daily

  6. STUDIES • European studies of placebo/control groups • Proved Folic Acid prevents Neural Tube Defects • Stopped study after two years due to unethical issues of causing birth defects to unborn babies

  7. Scientific Conclusion About Folic Acid Before and After Intake

  8. Utah’s Incidence Rate

  9. Chart on NTDS incidence rate according to race of mother

  10. Where do we get Folic Acid? • Leafy Greens (Spinach, beans) • Lentils • Whole Grains (fortified cereal products) • Some fruits • Supplements • Others?

  11. What is a Neural Tube Defect? • Defect of spine, skull • Occasional brain deformities • Defect of spine and nearby nerves to develop normally (fluid filled sac) • Defect of skull to close properly in-utero • Any abnormality in structural development of brain or spinal cord • 2:1000 babies born in USA will have NTD • Risk is increased worldwide

  12. KINDS OF NTDs • Spina Bifida-general term for myelomeningocele, a defect or split in formation of vertebra (other known names are meningomyelocele and spina bifida occulta-less severe form of NTD) • Anencephaly-defect in which brain is undeveloped or severely malformed, sometimes spine can be included • Exencephaly: skull is defective causing exposure/extrusion of brain • Encephalocele: sac like structure containing spinal fluid at the base of the neck or in the back of the head, skull is closed

  13. Spina Bifida

  14. Exencephaly

  15. Example of Closed Unrepaired NTD

  16. Variations of Spina Bifida

  17. Anencephaly

  18. Encephalocele

  19. Causes of Neural Tube Defects • Environmental (diet, folic acid deficiency, exposures during 1st trimester) • Genetics (previous child born with an NTD, English ancestry) • A little of both • 95 percent of the time: UNKNOWN

  20. Tests to Detect NTDs • MSAFP-maternal blood test done between 14-21 wks of pregnancy • Ultrasounds prenatally • Postnatal Radiology exams (CT, MRI) • Postnatal Surgery

  21. NTD closed (post surgery)

  22. How are NTDs fixed? • Surgery prenatal or postnatal • Depending on severity, child may die because of difficulty in repairing • Lifelong complications

  23. In Utero Surgery to fix an NTD

  24. Life After Surgery • Long term complications • Braces for legs • Wheelchairs • Therapy • Special Tutors • Physical complications

  25. Complications • Bowel/bladder function • Paralysis (paraplegic/quadriplegic) • Club feet • Motor skills • Ambulation • Skin Sensation • Weight/over eating • Seizures • Hydrocephalus • Visual Disturbances

  26. People involved in the care of NTDs • OB/GYN • Pediatrician • General Surgeon • Orthopedic Surgeon • Urologist • Neurosurgeon • Geneticist • OT/PT • Plastic Surgeon • Radiologist • Special Ed Teacher

  27. Life Down the Road • Can be normal human beings with a little extra thrown in • Can be independent • Can experience normal every day pleasures • Can learn to drive • Can maintain jobs • Can have families

  28. IMPORTANT NOTES(Conclusion) • Any woman who is pregnant or planning on pregnancy should consume 4 mg of Folic Acid on a daily basis • Encourage loved ones to start taking Folic Acid if not already doing so • Neural Tube Defects CAN be prevented • There is help for babies born with NTDs • Love the child NO MATTER WHAT because it’s a long and difficult journey ahead

  29. QUESTIONS??

  30. References • www.health.utah.gov/birthdefect • www.pregnancyriskline.org • www.google.com • www.wikepedia.org • Amy Nance, B.S., Study Coordinator, Utah Birth Defect Network • Utah Pregnancy Risk Line: Julia Robertson, Program Coordinator • www.cdc.gov • Children With Spina Bifida, 1999; Lutkenhoff, Marlene • A Parent’s Guide to Spina Bifida,1988; Bloom, Beth-Ann and Edward Seljeskog M.D.

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