EXPERT ADVICE: What’s that growth on my baby’s back?

In babies with spina bifida, a neural tube defect, the bones don’t form properly around part of their spinal cord…

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Your mini-me’s backbone is vital to them, since they will need it in order to move their body. It is also one of the first body parts to develop in your first trimester.

Your foetus’s brain and spinal cord are developed from a structure called the neural tube. This tube usually closes 28 days after conception. However, for some babies, the bottom end of the tube — near the lower back — fails to fuse, resulting in spina bifida.

The condition is detected in routine blood tests and ultrasounds during the first trimester, followed by another ultrasound or an MRI-scan to confirm it.

“Patients with a myelomeningocele will have life-long health issues such as lower limb paralysis and loss of sensation, as well as bladder and bowel dysfunction.”

Dr Darryl Lim, a paediatrician at Mount Alvernia Hospital’s Kinder Clinic, explains that there are three forms of this potentially devastating congenital condition:

* Spina Bifida Occulta Marked by a gap in the back bone, patients are usually unaware of the defect until it’s been uncovered incidentally through X-ray or scanning. This occurs in about two to three per cent of births here.

* Meningocele The tissues covering the spinal cord — called meninges — bulges through the gap in the backbones but does not affect the nerves or spinal cord. This bulge can be seen on the surface of baby’s skin and can be as small as a grape or as large as a grapefruit. Surgery can repair the defect with minimal to no damage to the spinal cord or nerves, says Dr Lim.

* Myelomenigocele In this most severe form of the condition, the meninges and spinal cord protrude outside the spinal cord. The exposed parts may be covered by a thin membrane or completely exposed to the outside. Prompt surgery is often needed after birth.

Dr Lim adds that the risk of developing spina bifida — specifically meningocele or myelomeningocele — is higher when one’s sibling is affected by it.

Incidentally, a child with myelomeningocele can also face life-long developmental issues. Dr Lim notes, “Patients with a myelomeningocele will have life-long health issues such as lower limb paralysis and loss of sensation, as well as bladder and bowel dysfunction.”

To lessen the chances that their babies suffer from this condition, mums-to-be should takes sufficient folic acid supplements during the early part of their pregnancy.

Dr Lim answers your questions about myelomenigocele…

Can surgery drain the fluid collected in the spinal cord?

As myelomeningocele may be associated with hydrocephalus and the excess fluid can exert pressure on the brain, the doctor may need to insert a ventriculo-peritoneal shunt — a medical device used to relieve pressure on the brain caused by built-up fluid. The shunt will help to drain the spinal fluid from the brain to the abdomen. Over time, these shunts can become [blocked] or infected. Hence, surgery may be needed to reinsert it.