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Neural tube defects and the role of folic acid in Lowering the Risk.pdf
1) Neural tube defects occur when the neural tube fails to close properly during early embryonic development, resulting in defects of the brain and spinal cord like anencephaly, encephalocele, and spina bifida. 2) Risk factors include genetic factors, maternal folic acid deficiency, obesity, use of some antiepileptic drugs, and environmental exposures. Tests like AFP, ultrasound, amniocentesis, and fetal karyotyping can help diagnose neural tube defects. 3) While neural tube defects cannot be cured, management may include surgery, folate supplementation, and ensuring proper prenatal nutrition to help prevent recurrence in future pregnancies.
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Neural tube defects and the role of folic acid in Lowering the Risk.pdf
- 1. GRACIOUS COLLEGE OFNURSING RAIPUR C.G. Neural tube defects and the role of folic acid in Lowering the Risk acid in Lowering the Risk PRESENTED BY OM VERMA ASSISTANT PROFESSOR
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- 3. INTRODUCTION The most commonbirth defect in India in neural tube defect Neural tube – Embryonic precursor to central nervous system which Embryonic precursor to central nervous system which is a made up of the brain and spinal cord. Neural tube Defect – it is a defect in the covering of the brain and spinal cord it is called Neural tube Defect.
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- 6. Neural tube defectit is a define as failure of closure of the neural tube during 3rd and 4th Week of pregnancy ( first month of embryonic life ) it is called neural tube defect . defect . According to simmons
- 7. TYPES OF NEURAL TUBEDEFECT
- 8. There are 3types of neural tube defect :- 1. Anencephaly 2. Encephalocele 2. Encephalocele 3. Spina Bifida
- 9. 1. ANENCEPHALY :- Anencephalyis a serious birth defect in which a baby is born without parts of the brain and skull. Anencephaly is a defect in the formation of a baby's neural tube during development. It is a type of neural tube defect , it occurs when the head end of a type of neural tube defect , it occurs when the head end of the neural tube fails to close .it is characterized by the absence of a major portion of the brain and skull .infants either die with in the uterus /die with in the few hours or days after birth.
- 11. Encephalocele happens whenthe neural tube does not close completely 2. ENCEPHALOCELE neural tube does not close completely during pregnancy. It is a neural tube defect characterized by Sac like protrusion of the brain through the opening in the skull.
- 12. ENCEPHALOCELE sac-like protrusions ofthe brain and the membranes that cover it through openings in the skull.
- 13. 3. SPINA BIFIDA Abirth defect in which a developing baby's spinal cord fails to develop properly. It occurs when a developing baby's spinal cord fails to It occurs when a developing baby's spinal cord fails to develop or close properly while in the fetus. Symptoms can sometimes be seen on the skin above the spinal defect. They include an abnormal tuft of hair, a birthmark or protruding spinal cord tissue.
- 15. Abnormal opening in the vertebral columnis called spina bifida
- 16. Their 3 typesof spina bifida 1. Spina bifida oculta 2. Meningocele 2. Meningocele 3. Meningomyelocele
- 18. 1. SPINA BIFIDAOCULTA Spina bifida occulta (SBO) is a common malformation of the spine. It occurs during a baby's development in its mother's uterus , Spina bifida occulta is when a baby's backbone (spine) does not fully form during pregnancy. The baby is born with a small gap in the bones of the spine. It is most common neural tube gap in the bones of the spine. It is most common neural tube defect which involves the spinal cord .it is caused by failure of the closure of lower portions of the neural tube .and visible sign is a dimple in the skin of the area or tuft of hair are present.
- 19. 2. MENINGOCELE Meninges andC.S.F. Are out from the defect and these are the covered by the a transparent membrane . A meningocele is a transparent membrane . A meningocele is a birth defect where there is a sac protruding from the spinal column. no nerve damage.
- 20. 3. MENINGOMYELOCELE Myelomeningocele isan NTD in which the bones of the spine do not completely form. This results in an incomplete spinal canal. The spinal cord and meninges incomplete spinal canal. The spinal cord and meninges protrude from the child's back. myelomeningocele, part of their spinal cord and nerves are in the sac and are damaged
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- 23. GENETIC FACTOR – Causedby a combination of multiple genes. neural tube defects can be caused by genes passed on from both caused by genes passed on from both parents (inherited). And genetic material abnormality present in both parents.
- 24. MATERNAL NUTRITION (including folicacid deficiency) during pregnancy poor diets lacking in key nutrients – like iodine, iron, folate, calcium and zinc – can cause anaemia, pre-eclampsia, haemorrhage and anaemia, pre-eclampsia, haemorrhage and death in mothers. They can also lead to stillbirth, low birthweight, wasting and developmental delays for fetus ,and neural tube defect.
- 25. ENVIRONMENTAL FACTORS That affectfetal development Smoking. Metals. Inhalational Anesthetics. Inhalational Anesthetics. Organic Solvents. Air Pollution. Pesticide Workers. Radiation. Stress.
- 26. POOR INTAKE FOLICACID Within the first 28 days of pregnancy, the neural tube, which is responsible for the development of the brain and spine, closes. Inadequate of the brain and spine, closes. Inadequate concentrations of folate can prevent closure of the neural tube, which can lead to a neural tube defect.
- 27. OBESE WOMEN More severeobesity carried a higher risk of birth defects, it's possible that health problems related to excess weight such as abnormal related to excess weight such as abnormal metabolism, increased sensitivity to the hormone insulin and impaired vascular function all might play a role to lead fetus NTD,
- 28. ANTIEPILEPTIC DRUGS (AED) Antiepilepticdrugs have chronic teratogenic effects, the most common of which are congenital heart disease, cleft lip/palate, and neural tube defects. Valproate and carbamazepine include minor Valproate and carbamazepine include minor anomalies, major congenital malformations, intrauterine growth retardation, cognitive dysfunction, low IQ, microcephaly, and infant mortality.
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- 32. Alpha Fetoprotein InAmniotic Fluid And Maternal Serum Test AFP test is a test that is mainly used to measure the level of alpha-fetoprotein (AFP) in the blood of a level of alpha-fetoprotein (AFP) in the blood of a pregnant person. The test checks the baby's risk for having certain genetic problems and birth defects. such as neural tube defects or Down syndrome
- 33. ACETYLCHOLINESTERASE (AChE) TEST Raisedspecific acetyl-cholinesterase (AChE) activity in amniotic fluid was consistently found to be associated with consistently found to be associated with fetal intrauterine death and neural tube defects,
- 34. FETAL KARYOTYPING TEST Thistest can help identify genetic problems as the cause of a disorder or disease. Karyotyping is a test used to identify chromosome abnormalities as identify chromosome abnormalities as the cause of malformation or disease. The test can be performed on a sample of blood, bone marrow, amniotic fluid, or placental tissue.
- 35. Fetal (prenatal) ultrasound: Anultrasound during pregnancy is the most accurate method to diagnose several NTDs. Healthcare providers typically recommend Healthcare providers typically recommend ultrasounds during the first trimester (11 to 14 weeks of pregnancy) and second trimester (18 to 22 weeks of pregnancy).
- 36. Amniocentesis: Healthcare providers usethis test to check for NTDs and other birth defects. During amniocentesis, they use a needle to remove amniocentesis, they use a needle to remove a sample of fluid from the amniotic sac that surrounds te fetus. You can get this test at 15 to 20 weeks of pregnancy. This test carries certain risks
- 37. Management There is nocure for neural tube defects. The nerve damage and loss of function that The nerve damage and loss of function that are present at birth are usually permanent. But some management for some birth defect.
- 39. Folate (folic acid)deficiency: Folate, the natural form of vitamin B-9, is important for healthy fetal development. A folate deficiency before and during pregnancy increases the risk of having a baby with spina bifida and other NTDs. The having a baby with spina bifida and other NTDs. The Centers for Disease Control and Prevention (CDC) recommends all people who can become pregnant take 400 micrograms (mcg) of folic acid every day, in addition to eating food with folate, to help prevent NTDs.
- 40. Surgical management Surgery forNeural Tube Defects If the child's spinal cord is exposed to the skin, early surgical repair is essential to prevent infection and surgical repair is essential to prevent infection and neurological deficits. Protrusion of sac can be closed surgically after which assessment of growth and development should be continued .
- 43. Prevention: To preventthe first occurrence of neural tube defects, all women planning a pregnancy should adopt the following: 1. Diet of women planning a pregnancy should be supplemented with folic acid. 2. Processed food such as bread, cereals, flour and other grains product which are fortified with folic acid should be used. 3. Consume more folate rich foods and avoid overcooking which destroy the folic acid.