Concept map
Spina Bifida
Concept map
SPINA BIFIDA
Health
PromotionCognitive/
Behavioral
Impacts
Spina Bifida Occulta (SBO)
Spina Bifida Cystica (SBC)
All women of childbearing age, whether they are trying to
conceive or not, should consume 0.4mg of folic acid per day to
prevent having a child with spina bifida; women who have
previously had a child with spina bifida should consume 4mg of
folic acid per day
1,645 babies are born with spina bifida every year in the
United States Hispanic women
have the highest rate of having a child with
spina bifida
Prevention
Health MeasuresImpaired mobility and
urinary and bowel incontinence can cause delays in developmental milestones, such as toilet training; spina bifida can
also have impacts on long- term milestones like forming
sexual relationships and child-bearing
Complications such as hydrocephalus,
seizures, and infections can
cause cognitive delays
Assessment Findings
Lab Studies
Imaging
Diagnosis
Environmental
Factors
Treatment
Diagnosis is based on clinical manifestations and examination
of the meningeal sac Neurological exams can
determine the impact on bowel and bladder function and the neuromuscular affect on the
lower extremities
MRIs, CTs, and ultrasounds can be used to evaluate the
brain and spinal cord Prenatal ultrasounds can also be used to scan the uterus for signs of neural tube defects
prior to birth
Amniotic fluid can be tested during pregnancy for indications of neural tube defects, such as elevated levels of α-
fetoprotein
Signs &
Symptoms
SBO is not always apparent on inspection
and may be asymptomatic
Possible cutaneous manifestations include: a
skin depression or dimple, dark tufts of hair, or port-
wine nevi
A visible, external, sac-like protrusion on the lumbrosacral area S/S vary based on the degree and location of the spinal defect, and
can include: Sensory impairment, partial
paralysis of the lower extremities, overflow incontinence, lack of bowel control, bladder and anal sphincter paralysis, rectal prolapse, and
joint deformities Demographics
Fecal continence can often be restored with
proper nutrition (adequate fiber intake), regular bowel training, and
constipation prevention
50-70% of neural tube defects could be
prevented with adequate folic acid intake; thus, lack of education and access to quality, fortified foods greatly increase the risk of giving birth to a child
with spina bifida
Surgical closure of the sac is recommended within the first 24 hours to prevent complications such as infection,
rupture, and trauma to the exposed tissue Broad-spectrum antibiotics are
initiated early for infection prevention Physical therapy may be necessary if there are musculoskeletal deformities
Clean intermittent catheterization, temporary urinary diversion, or
augmentation enterocystoplasty may be required depending on the level of
bladder dysfunction
A genetic anomaly resulting in a fissure in the spinal
column, leaving the meninges and spinal cord exposed.
Spina bifida is a neural tube defect that occurs during embryonic development.
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