NEURAL TUBE

DEFECTS National Ribat University

Faculty of Dentistry
Batch 20
TABLE OF CONTENTS
INTRODUCTION TYPES
01 02
CAUSES AND RISKS SYMPTOMS
03 04
DAIGNOSIS AND TESTS PREVENTION AND TREATMENT
05 06
01 INTRODUCTION
Introduction
NTDs are birth defects of the brain and spinal cord.

Normally starts out as a tiny, flat ribbon that turns into a tube by the end of the first month
of pregnancy causing problems in overall health, how the body develops or how the body
works.

If the tube doesn’t close completely, an NTD can happen. NTDs can cause serious problems
for babies, including death

The two most common NTDs are Spina bifida and Anencephaly
 TYPES
02
TYPES OF NTD
1- Spina bifida
2- Anencephaly
3- Ecephalocele
4- Iniencephaly
5- Craniorachischisis
SPINA BIFIDIA SPLIT
A-SPINA BIFIDIA OCCULTA:
a. Mildest and most common
b. One or more vertebrae of the spinal column are
malformed
c. Rarely causes disability
d. No symptoms, but often found accidentally.
e. Hair dimple and birth marks in the area of defect.
B-SPINA BIFIDIA MENINGOCELE
a. More sever and less common .
b. The spinal fluid with the meninges pokes through
the spine.
c. Does not contain nerve.
d. May or may not be covered by skin.
e. Has minor symptoms .
B-SPINA BIFIDIA Myelomeningocele
a. Most sever and least common
b. Portion of the spinal cord or nerves is exposed
and may or may not be covers by meninges.
c. Causes changes in the brain structure
d. Serious damage increases risks of infections.
2nd Type : ANENCEPHALY
In this type the Neural tube dose not close at the top.

A. the skull, scalp and brain not to develop properly.

B. portions of the brain and skull are missing.
C. Infants are either stillborn or die soon after birth.
3rd Type : ENCEPHALOCELE
A. The neural tube doesn’t close near the brain.
B. There’s an opening in the skull.
C. The fetus's brain and the membranes that cover it can protrude through the
skull, forming a sac-like bulge.
4th Type : INIENCEPHALY
A. The spine is severely malformed (misshapen).
B. Causes a lack of a neck, and your baby’s head is bent severely backward.
C. The skin of your baby’s face is connected
to their chest .
D. The scalp is connected to their back.
E. Babies with iniencephaly are usually
stillborn.
5th Type : CRANIORACHISCHISIS
A. The neural tube does not closes at all.
B. Very rare.
C. Completely open brain and the spinal.
 CAUSES OF ABNORMALITIES
03 & RISKS
ETIOLOGY
Exact Causes of NTDs aren't known.
Experts think some may be caused by:

1- Genetics. This means an NTD can be passed from parents to children through genes.

2- Environment, which includes; where you live, work, the kinds of foods you eat or have
access to, and how you like to spend your time. Some things in your environment can be
harmful to a pregnancy, like certain drugs, cigarette smoke, air pollution.

3- Maternal nutrition including folic acid deficiency during pregnancy.

RISKS
if you had baby with an NTD, there is a 2-to-3 percent chance of having a baby
with an NTD in another pregnancy. There are also RISKS FACTORS INCLUDE:
1-Taking certain Anti-Seizure medicines.
2-Obesity.
3-Diabetes.
4-Using opioids in the first 2 months of pregnancy, this opioids include codeine, hydrocodone and
oxycodone, it causes serious problems for the baby, like Premature birth and Neonatal Abstinence
Syndrome (NAS).
5- A High body temperture early in pregnancy, this may be caused by a fever.
 NOTE

Consider that Neural tube defects (NTDs) happen to developing

fetuses within the first month of pregnancy. An NTD happens
when the neural tube doesn’t close completely somewhere
along its length.
 SYMPTOMS &
04 COMPLICATIONS
SYMPTOMS
1- Physical problems
2-Blindness.
3-Deafness
4- Intellectual disability
5- Lack of consciousness
6-Death.
Physical Symptoms include:
A. Paralysis
B. Urinary
C. bowel control problems.
 DIAGNOSIS AMD TESTS
05
DIAGNOSIS
NTDs are usually diagnosed during pregnancy, through laboratory or imaging tests. You can
get prenatal tests to find out if your baby is at increased risk of having an NTD. Screening
tests for NTDs include:
1-Maternal blood screening (done between 15 to 22 weeks of pregnancy)
2-Ultrasound Examination (16 to 20 weeks of pregnancy)

If a screening test shows an increased risk of NTDs, your provider may recommend a
diagnostic test to find out for sure if your baby has an NTD. Diagnostic tests for NTDs include
Amniocentesis and Detailed ultrasound of your baby’s skull and spine
MEDICAL TESTS
01 AMNIOCENTESIS
Doctor takes a small amount of the fluid around the fetus
with a thin needle. The fetus is NOT touched, the sample can
show if the baby have NTDs or not. You can get the test's
results within 3 day.
02 DETAILED ULTRASOUND OF BABY'S SKULL AND SPINE
Ultrasound examination is an effective modality for prenatal
diagnosis of neural tube defects (NTDs)
ACCURACY

98% 100%

AMNIOCENTESIS Ultrasound Imaging

The accuracy of amniocentesis is about an ultrasound should be 100 percent
98% in detecting abnormalities. accurate. If there is an NTDs, the
However, it doesn’t measure the ultrasound will detect it with ease.
severity of the condition.
What lab test is used to screen neural
tube defects during pregnancy?
The maternal serum screen is a simple blood test used to
identify if a woman is at increased risk for having a baby with
certain birth defects, such as neural tube defects or
chromosomal disorders such as Down syndrome
06 PREVENTION AND TREATMENT
TREATMENT
Specific treatment depends on the type of neural tube defect and the severity of the condition

The ideal treatment approach involves multiple specialties in reviewing the cases of children
with neural tube defects, including pediatric neurosurgeons, pediatric neurologists, and
pediatric urologists, among others
The newborn with an open NTD should be kept warm and the defect covered with a sterile wet
saline dressing, with consideration for prophylactic antibiotics. The patient should be
positioned in the prone position to prevent pressure on the defect
Spina Bifidia Treatment
Treatment for spina bifida will typically include one or more surgeries to help
fix the defect; however, there is NO TRATMENT for any nerve damage caused by the
malformation.
Many babies born with spina bifida also have hydrocephalus, which causes the
head to swell from excess fluid buildup.
Treatment for hydrocephalus includes insertion of a shunt to help drain the fluid and release the
pressure inside the cranium. Additional therapy may also be needed for walking or bowel and
bladder management. Most complications from spina bifida can be treated or managed to improve
quality of life.
Encephalocele Treatment
The size, location and type of encephalocele will impact a baby’s
survival of this condition, their quality of life after birth and the
appropriate treatment for their condition.
Surgery will be done to place the protruding sac of the brain and
membranes back into the skull and close the opening.
In some cases, Multiple surgeries may be needed due to the location and region affected.
While surgical treatment for the opening is typical, any neurological problems caused by this
condition are permanent.
Anencephaly Treatment
There is currently no standard treatment for anencephaly

Infants with these conditions usually die shortly after birth

 PREVENTION
06
Indications
Including the recommended amount
of folic acid in your diet (400 mcg a
day) can help prevent neural tube
defects from developing in the early
stages of your pregnancy
Talking to a Genetic Counselor
about the risk of NTDs in future
pregnancies is advisable.
Contraindications
Using Opoids in the first 2 months of
pregnancy this opioids include
codeine, hydrocodone and
oxycodone.
Using certain anti-seizure
medicines
THE
END