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woman with spina bifida and pregnancy

Pei-Yin Yang, Ching-Hua Wu, Guang-Perng Yeh, Charles Tsung-Che Hsieh
OBJECTIVE: Here, we report a case of parapagus diprosopus twins with spina bifida diagnosed in the first trimester of pregnancy using two-dimensional (2D) and three-dimensional (3D) ultrasound. CASE REPORT: A 28-year-old Taiwanese woman, gravid 1, para 0, visited our hospital due to an abnormal fetal head shape discovered by 2D ultrasound at 11-weeks gestation. Parapagus diprosopus twins with spina bifida were diagnosed after ultrasound examination. The characteristics of parapagus diprosopus twins are more illustrative in 3D ultrasound than in 2D ultrasound...
December 2015: Taiwanese Journal of Obstetrics & Gynecology
Jairam R Eswara, Stephanie Kielb, Martin A Koyle, Dan Wood, Hadley M Wood
OBJECTIVE: To develop consensus recommendations for index congenital urological cases seen in adulthood and to generate discussion among providers who treat these patients across the lifespan. This manuscript reviews the proceedings and recommendations of the 2015 American Urological Association Working Group on Urological Congenitalism. METHODS: Index cases were selected to highlight controversies in the management of different congenital patients in adulthood...
February 2016: Urology
Atsuo Kondo, Hiromi Fukuda, Takuya Matsuo, Keiko Shinozaki, Ikuyo Okai
We analyzed the role of maternal C677T mutation in methylenetetrahydrofolate reductase (MTHFR) gene on spina bifida development in newborns. A total of 115 mothers who had given birth to a spina bifida child (SB mothers) gave 10 mL of blood together with written informed consent. The genotype distribution of C677T mutation was assessed and compared with that of the 4517 control individuals. The prevalence of the homozygous genotype (TT) among SB mothers was not significantly different from that among the controls (odds ratio [OR] = 0...
February 2014: Congenital Anomalies
Glen Melanson
Suppose a physician advises a woman to delay her planned pregnancy for a few months in order to significantly reduce the likelihood that her baby will suffer with Spina Bifida. If the woman chooses to ignore this advice and conceives soon after, I believe most people would consider it a matter of common sense that the child thus born is a victim of this woman's negligence, even if it is fortunate enough to not be burdened with Spina Bifida. This common sense judgement appeared to have been done in by the fact that the timing of conception can be identity-influencing, and so the child that is born only exists because of its mother's decision to ignore her physician's advice...
August 2013: Journal of Medicine and Philosophy
Leila Etemad, Mohammad Moshiri, Seyed Adel Moallem
Approximately 1% of all pregnancies are in woman with epilepsy. Although, the majority of children born to women with epilepsy are normal, they are at increased risk for malformations. Notably, the teratogenicity of antiepileptic drugs is a well-defined subject. The incidence of major malformations in offspring of mothers with epilepsy who were treated with AEDs is higher than women with untreated epilepsy and in the general population. These malformations include spina bifida, cleft palate, limb reduction defects, cardiac abnormalities, hypospadias, and gastrointestinal atresia...
September 2012: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Agnieszka Seremak-Mrozikiewicz
Proper metabolism of folates has a crucial role for body homeostasis. Folate metabolism regulates changing of amino acids (homocysteine and methionine), purine and pyrimidine synthesis and DNA methylation. These whole biochemical processes have significant influence on hematopoietic, cardiovascular and nervous system functions. The disturbances of folate cycle could result in chronic hypertension, coronary artery disease, higher risk of heart infarction, could promote cancers development, and psychic and neurodegenerative diseases...
May 2013: Ginekologia Polska
Mehmet S Kutuk, Mahmut Tuncay Ozgun, Semih Uludag, Hulya Akgun, Burhan Balta
BACKGROUND: The schisis theory suggests that neural tube defect (NTD), cleft lip and palate (CL/P), omphalocele and diaphragmatic hernia are associated to each other more frequently than at the expected random combination rates in a given fetus. However, it is unusual to see schisis-associated defects concordantly in dichorionic twin pregnancy with other schisis-associated and non-associated defects. In addition, the association of lower limb oligodactly with oral cleft and spina bifida has not been reported before...
October 2013: Fetal and Pediatric Pathology
Badawy A B Khitamy
A Muslim woman in her sixteenth week of pregnancy was informed that her ultrasound scan showed spina bifida, and laboratory results confirmed the diagnosis. The child would have various complications and, most probably, would need medical care for life. With the consent of her husband she decided to terminate the pregnancy. Her decision sparked controversy among Muslim clerics in her community, sparking debate between those who would allow abortion for medical reasons and those who oppose abortion for any reason...
February 2013: Sultan Qaboos University Medical Journal
(no author information available yet)
Myelomeningocele, the most severe form of spina bifida, occurs in approximately 1 in 1,500 births in the United States. Fetuses in whom myelomeningocele is diagnosed typically are delivered at term and are treated in the early neonatal period. A recent randomized controlled trial found that fetal surgery for myelomeningocele improved a number of important outcomes, but also was associated with maternal and fetal risks. Maternal-fetal surgery is a major procedure for the woman and her fetus, and it has significant implications and complications that occur acutely, postoperatively, for the duration of the pregnancy, and in subsequent pregnancies...
January 2013: Obstetrics and Gynecology
Alex J Eggink
Spina bifida is the most common congenital birth defect involving the central nervous system. It results in central and peripheral abnormalities. Patients with severe spina bifida may have a lifelong disability with dependence on medical and social supportive care. A randomized controlled trial demonstrated that, for a selected number of patients, prenatal closure of the defect resulted in a better neurological outcome than postnatal surgical repair. Prenatal surgery of spina bifida is associated with an increased risk of preterm birth and obstetric complications and is not yet considered the standard of care in the Netherlands...
2012: Nederlands Tijdschrift Voor Geneeskunde
Mehmet Serdar Kutuk, Mahmut Tuncay Ozgun, Mustafa Tas, Hatice Gamze Poyrazoglu, Ali Yikilmaz
INTRODUCTION: Split cord malformation (SCM) is rare congenital disorder of spine in which bony, fibrous, or cartilaginous septum subdivides partially or completely the vertebral canal. SCM can be associated with other spinal abnormalities such as spina bifida, Arnold-Chiari malformation, hemivertebra, butterfly vertebra, or kyphoscoliosis and also can be seen as part of Jarcho-Levin syndrome. Prenatal diagnosis of SCM is possible by ultrasonography (US). Fetal magnetic resonance imaging (MRI) and amniotic fluid acetylcholine esterase (AF-AChE) levels can be helpful to rule out additional anomalies...
December 2012: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Coryn Stansfield
With the increased advancements of corrective surgery for babies with spina bifida, more women these days affected by spina bifida are reaching child bearing age and having children of their own. This poses both obstetric an medical challenges to ensure the safe care of both the mother and child. This case study explores the healthcare needs of the woman with spina bifida and the medical and obstetric challenges that are posed, particularly in the antenatal period. It examines the role of the midwife in providing holistic co-ordinated care to ensure that the outcome is both positive and empowering...
June 2012: Practising Midwife
Lavinia Gheorman, D Iliescu, Iuliana Ceauşu, Daniela Paulescu, I E Pleşea, V Gheorman
We report and analyze a case of pregnancy associated with pre-existent diabetes mellitus and fetal congenital anomalies involving neural tube defect (NTD) and congenital heart defect (CHD). We discuss the early antenatal management of such high-risk pregnancies. The clinical course, maternal paraclinic profile and morpho-sonographic investigation of the fetus are described. A 28-year-old pregnant woman with pre-existing diabetes and a pre-pregnancy BMI 31 kg/m², without preconception counseling for optimization of glycemic control was evaluated in our center for first trimester genetic screening at 12 weeks of gestation...
2011: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Immacolata Blasi, Adriano Ferrari, Giuseppina Comitini, Valeria Vinci, Martino Abrate, Giovanni Battista La Sala
The improvement of antenatal management and surgical techniques has greatly increased the survival rate of infants with spina bifida. More of these women are reaching adulthood and reproductive age and therefore could become pregnant. Pregnancy complications depend on the kind of spina bifida and subject's condition.We report a case of woman with a severe kyphoscoliosis, that progressively affects lung capacity until 32 weeks of gestation, when she underwent caesarean section.These patients deserve careful obstetric care, genetic counselling and urological, obstetric, neurological and anaesthetic management...
July 2012: Journal of Maternal-fetal & Neonatal Medicine
Pierpaolo Mastroiacovo, Emanuele Leoncini
In recent years, a number of studies have been performed to evaluate the possible health benefits of an increased intake of folic acid (FA) on human health. However, the only well-documented benefit emerging from randomized controlled trials, nonrandomized interventions trials, and observational studies is the risk reduction of neural tube defects (NTDs). NTDs are congenital malformations that include anencephaly, encephalocele, and spina bifida caused by the failure of fusion of the neural tube that normally closes between 22nd and 28th day since conception (on an average 40-42th day after the first day of last menstrual period)...
July 2011: BioFactors
Savita R Singhal, Smiti Nanda, Suresh K Singhal
INTRODUCTION: Seizures in pregnancy usually result from eclampsia, epilepsy or central nervous system disorders. Neurocysticercosis is a rare, but an important, cause of first-time convulsions in pregnancy. CASE PRESENTATIONS: We report the cases of two Indian women, aged 20 and 24 years old respectively, with neurocysticercosis presenting in the second trimester of pregnancy with convulsions. Both had marginally raised blood pressure with 1+ urine albumin and neither had a past history of convulsions...
2011: Journal of Medical Case Reports
Chih-Ping Chen, Yu-Peng Liu, Fuu-Jen Tsai, Chen-Yu Chen, Hung-Hung Lin, Pei-Chen Wu, Wayseen Wang
OBJECTIVE: To present the prenatal magnetic resonance imaging (MRI) findings of concomitant craniorachischisis and omphalocele, review the literature, and discuss the pathogenesis. CASE REPORT: A 20-year-old, gravida 2, para 0, woman was referred to genetic counseling at 17 weeks of gestation because of multiple congenital malformations in the fetus. Level II ultrasound revealed acrania, a ventricular septal defect, an upward-turned face, and omphalocele containing the intestines...
September 2009: Taiwanese Journal of Obstetrics & Gynecology
Patrick L Wilson, Jean Ricci Goodman, Katie M Smith, Andrew F Wagner
BACKGROUND: Anencephaly occurs in 1.4-4.7 per 10,000 deliveries and is thought to result from failed closure of the anterior neuropore at 24-26 days post fertilization. Among twins, risk for congenital malformations is greatest among monozygotic twins. Several occurrences of twin pairs being discordant for neural tube defects have been reported: 1 twin affected with anencephaly and co-twin affected with holoprosencephaly, spina bifida or encephalocele, is consistent with a multifactorial pattern of inheritance...
June 2009: Journal of Reproductive Medicine
S van de Vathorst, A A E Verhagen, H I J Wildschut, H Wolf, G G Zeeman, J Lind
The recently introduced ultrasonographic screening programme for the detection of fetal structural anomalies at 20 weeks' gestation is leading to a growing number of cases with an unclear prognosis. This article presents the decision-making process which followed the screening of two women: one aged 36 years, where a post-screening work-up was conducted and swiftly led to well-balanced decision making to abort a fetus with trisomy 21, and one woman aged 30 years, in whom repeated non-decisive results of further diagnostic tests ultimately led to a hasty decision to abort the pregnancy...
November 29, 2008: Nederlands Tijdschrift Voor Geneeskunde
Karen N Bell, Godfrey P Oakley
BACKGROUND: The number of countries fortifying wheat and maize flour with folic acid has increased in the past 2 years. Folic acid prevents most cases of spina bifida and anencephaly by raising serum folate levels among women capable of bearing children, as does encouraging women to consume folic acid supplements prior to pregnancy. METHODS: The progress in preventing these serious birth defects can be measured by tracking the number of countries now fortifying and program coverage in each...
January 2009: Birth Defects Research. Part A, Clinical and Molecular Teratology
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