Rascjep Neuralne Cijevi

Dorotea Ninković;

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ABSTRACT

Myelomeningocele, a common birth defect caused by incomplete closure of the spinal cord, is associated with significant morbidity and mortality. In the last forty years, little progress has been made in the postnatal surgical management of the child with spina bifida – an infection and further damage of neural elements are prevented, the leakage of the cerebrospinal fluid is stopped, and ventriculoperitoneal drainage is placed. Patients with meningomyelocele struggle with a multitude of problems: impaired mobility or immobility, stool incontinence or constipation, neurogenic bladder and chronic renal failure, tension hydrocephalus, intellectual difficulties, etc. In the last ten years, hope for the improvement of these patients has been raised by the possibility of prenatal surgery, for now, only in foreign centers. However, complications in the form of membrane rupture, oligohydroamnia, premature birth, and uterine rupture are very frequent. Advances in minimally invasive fetoscopic techniques should reduce the incidence of complications and continue to improve outcomes in patients with meningomyelocele.

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