Treatment:

Genetic counseling may be recommended. In some cases where severe defect is detected early in the pregnancy, a therapeutic abortion may be considered.

After birth, surgery to repair the defect is usually recommended at an early age. Before surgery, the infant must be handled carefully to reduce damage to the exposed spinal cord. This may include special care and positioning, protective devices, and changes in the methods of handling, feeding, and bathing.

Antibiotics may be used to treat or prevent infections such as meningitis or urinary tract infections.

Gentle downward pressure over the bladder may help drain the bladder. In severe cases, drainage tubes, called catheters, may be needed. Bowel training programs and a high fiber diet may improve bowel function.

Orthopedic or physical therapy may be needed to treat musculoskeletal symptoms. Neurological losses are treated according to the type and severity of function loss.

Follow-up neurologic testing as the child gets older helps to guide rehabilitation.

Support Groups:

See: Spina bifida resources

Expectations (prognosis):

A myelomeningocele can usually be surgically corrected. With treatment, length of life is not severely affected. Neurological damage is often irreversible.

Complications:

• Difficult delivery with problems resulting from a traumatic birth, including cerebral palsy and decreased oxygen to the brain
• Frequent urinary tract infections
• Hydrocephalus
• Loss of bowel or bladder control
• Meningitis
• Permanent weakness or paralysis of legs

This list may not be all inclusive.

Calling your health care provider:

Call your health care provider if:

• A sac sticks out of the spine of a newborn infant.
• The child is late in walking or crawling
• Symptoms of hydrocephalus develop, including bulging soft spot, irritability, extreme sleepiness, and feeding difficulties
• Symptoms of menigitis develop, including fever, stiff neck, irritability, and a high-pitched cry