Spina Bifida Myelomeningocele: An Annotated

Spina Bifida Myelomeningocele: An Annotated Bibliography

Spina bifida myelomeningocele is a devastating diagnosis for a child and research into its causes, diagnosis, and treatment has wide-ranging implications both for the families involved and the larger medical community. Many of the studies herein deal with screening processes for the condition and discussions of controversial subjects such as in utero surgery and early termination of pregnancy. Other studies delve into the longer-term prognosis of spina bifida myelomeningocele patients. The literature suggests that research into this field is only in its nascent stage, as much more needs to be learned about causal factors, prevention (though several studies make mention of the use of folic acid supplements during pregnancy), and eventually a cure, whether that be achieved through genetic testing, fetal surgery, or otherwise.

Aaronson, O.S., Hernanz-Schulman, M., Bruner, J.P., Reed, G.W., & Tulipan, N.B.

(2003). Myelomeningocele: Prenatal Evaluation Comparison between Transabdominal U.S. And MR Imaging. Radiology, 227(3), 839-843. doi: 10.1148/radiol.2273020535

This source compares ultrasound and magnetic resonance technology for use in fetuses identified as having spina bifida myelomeningocele, specifically in determining location of the lesion on the spine. The findings were that the methods were close to equally accurate; however both have the drawbacks of an over 20% rate of misdiagnosis. The article is useful in that it comes from a screening perspective, as early diagnosis is crucial in aiding with decision-making for families of children with spina bifida.

Boyles, a.L., Billups, a.V., Deak, K.L., Siegel, D.G., Mehltretter, L., Slifer, S.H. […] & Worley, G. (2006). Neural tube defects and folate pathway genes: Family-based association tests of gene-gene and gene-environment interactions. Environmental Health Perspectives, 114(10), 1547-1552. Retrieved April 1, 2011, from http://www.jstor.org/stable/3838179

Study of folate metabolism, as folic acid intake in expectant mothers is suspected of having some preventative value for myelomeningocele. This issue is addressed in a great deal of the field of research for this condition, as little is known about the cause of spina bifida. Specifically the article addresses the use of folic acid supplements.

De Wals, P., Rusen, I.D., Lee, N.S., Morin, P., & Niyonsenga, T. (2003). Trend in prevalence of neural tube defects in Quebec. Birth Defects Research Part a: Clinical

and Molecular Teratology, 67(11), 919-923. doi: 10.1002/bdra.10124

An inquiry into the screening and early detection of spina bifida among the population of Quebec. The research also addresses early pregnancy termination. In addition, this article also touches upon the use of folic acid supplements during pregnancy for the prevention of myelomenginocele. Studies focusing on small populations and how this condition is managed within those populations are interesting because they provide an alternate perspective for the reader who is used to the American medical system.

Hunt, G., Lewin, W., Gleave, J., & Gairdner, D. (1973). Predictive factors in open myelomeningocele with special reference to sensory level. The British Medical

Journal, 4(5886), 197-201. doi: 10.1136/bmj.4.5886.197

This study assessed the overall disability of children born with myelomeningocele who received surgery for the condition shortly after birth. In an effort to prevent surgery which is often fatal, predictive factors were examined and a correlation between sensory level and outcome of the surgery was found. As with the article in Radiology, this research is insightful in its presentation of how early screening interventions can influence whether families decide to pursue surgical interventions for children with the condition.

Hunt, G.M. (2003). Outcome in people with open spina bifida at age 35: Prospective community-based cohort study. BMJ: British Medical Journal, 326(7403), 1365-1366.

doi: 10.1136/bmj.326.7403.1365

A survey of surviving adults with spina bifida myelomeninocele was conducted. The study looked at multiple aspects of the person's life including hospitalization, independence of lifestyle, associated health problems, and present level of disability. Studies of adults with spina bifida were not well represented in the larger field of research; as such, this article provides invaluable insights into the ongoing care that is required for surviving patients.

Lindgren, C.L., Burke, M.L., Hainsworth, M.A., & Eakes, G.G. (1992). Chronic sorrow:

A lifespan concept. Scholarly Inquiry for Nursing Practice, 6(1), 27-40. Retrieved April 1, 2011, from http://www.questia.com/PM.qst?a=o&d=5035235041

A more global perspective on how parents of children with chronic illness channel their grieving. The article addresses myelomenginocele in terms of psychological effects it has on families. It briefly addresses the profound impact of the severe disability of a child and discusses coping strategies.

Moretti, M.E., Bar-Oz, B., Fried, S., & Koren, G. (2005). Maternal hyperthermia and the risk for neural tube defects in offspring. Epidemiology, 16(2), 216-219. doi: 10.1097/01.ede.0000152903.55579.15

This article concerns a systematic review of several studies into myelomeningocele in the interest of determining whether a mother's high body temperature could cause risk of an infant developing the condition in utero. The study found that maternal hyperthermia did increase risk.

Norup, M. (1998). Limits of neonatal treatment: A survey of attitudes in the Danish population. Journal of Medical Ethics, 24(3), 200-206. doi: 10.1136/jme.24.3.200

Similar to the Canadian study previously discussed, this is a look at the controversy behind life-prolonging treatment from the perspective of Danish citizens. A survey was sent out to measure whether the general public felt that infants with myelomeningocele should be kept alive by treatment, taking into account parental desires, severity of condition, and quality of life in cases where treatment was not possible. The article is an interesting exploration into cultural perspectives on disability.