Maternity
Spina Bifida
Concept map
SPINA BIFIDA
Health
PromotionCognitive/
Behavioral
Impacts
Spina Bifida
Occulta (SBO)
Spina Bifida
Cystica (SBC)
All women of childbearing age,
whether they are trying to
conceive or not, should consume
0.4mg of folic acid per day to
prevent having a child with spina
bifida; women who have
previously had a child with spina
bifida should consume 4mg of
folic acid per day
1,645 babies are born
with
spina bifida
every year in the
United States
Hispanic women
have the highest rate
of having a child with
spina bifida
Prevention
Health
MeasuresImpaired mobility and
urinary and bowel
incontinence can cause
delays in developmental
milestones, such as toilet
training; spina bifida can
also have impacts on long-
term milestones like forming
sexual relationships and
child-bearing
Complications such
as hydrocephalus,
seizures, and
infections can
cause cognitive
delays
Assessment
Findings
Lab
Studies
Imaging
Diagnosis
Environmental
Factors
Treatment
Diagnosis is based on clinical
manifestations and examination
of the meningeal sac
Neurological exams can
determine the impact on bowel
and bladder function and the
neuromuscular affect on the
lower extremities
MRIs, CTs, and ultrasounds
can be used to evaluate the
brain and spinal cord
Prenatal ultrasounds can also
be used to scan the uterus for
signs of neural tube defects
prior to birth
Amniotic fluid can be
tested during pregnancy
for indications of neural
tube defects, such as
elevated levels of α-
fetoprotein
Signs &
Symptoms
SBO is not always
apparent on inspection
and may be
asymptomatic
Possible cutaneous
manifestations include: a
skin depression or dimple,
dark tufts of hair, or port-
wine nevi
A visible, external, sac-like
protrusion on the lumbrosacral area
S/S vary based on the degree and
location of the spinal defect, and
can include:
Sensory impairment, partial
paralysis of the lower extremities,
overflow incontinence, lack of bowel
control, bladder and anal sphincter
paralysis, rectal prolapse, and
joint deformities
Demographics
Fecal continence can
often be restored with
proper nutrition (adequate
fiber intake), regular
bowel training, and
constipation prevention
50-70% of neural tube
defects could be
prevented with adequate
folic acid intake; thus, lack
of education and access
to quality, fortified foods
greatly increase the risk
of giving birth to a child
with spina bifida
Surgical closure of the sac is
recommended within the first 24 hours to
prevent complications such as infection,
rupture, and trauma to the exposed tissue
Broad-spectrum antibiotics are
initiated early for infection prevention
Physical therapy may be necessary if
there are musculoskeletal deformities
Clean intermittent catheterization,
temporary urinary diversion, or
augmentation enterocystoplasty may be
required depending on the level of
bladder dysfunction
A genetic anomaly resulting
in a fissure in the spinal
column, leaving the meninges
and spinal cord exposed.
Spina bifida is a neural tube
defect that occurs during
embryonic development.
Spina Bifida
Concept map
SPINA BIFIDA
Health
PromotionCognitive/
Behavioral
Impacts
Spina Bifida
Occulta (SBO)
Spina Bifida
Cystica (SBC)
All women of childbearing age,
whether they are trying to
conceive or not, should consume
0.4mg of folic acid per day to
prevent having a child with spina
bifida; women who have
previously had a child with spina
bifida should consume 4mg of
folic acid per day
1,645 babies are born
with
spina bifida
every year in the
United States
Hispanic women
have the highest rate
of having a child with
spina bifida
Prevention
Health
MeasuresImpaired mobility and
urinary and bowel
incontinence can cause
delays in developmental
milestones, such as toilet
training; spina bifida can
also have impacts on long-
term milestones like forming
sexual relationships and
child-bearing
Complications such
as hydrocephalus,
seizures, and
infections can
cause cognitive
delays
Assessment
Findings
Lab
Studies
Imaging
Diagnosis
Environmental
Factors
Treatment
Diagnosis is based on clinical
manifestations and examination
of the meningeal sac
Neurological exams can
determine the impact on bowel
and bladder function and the
neuromuscular affect on the
lower extremities
MRIs, CTs, and ultrasounds
can be used to evaluate the
brain and spinal cord
Prenatal ultrasounds can also
be used to scan the uterus for
signs of neural tube defects
prior to birth
Amniotic fluid can be
tested during pregnancy
for indications of neural
tube defects, such as
elevated levels of α-
fetoprotein
Signs &
Symptoms
SBO is not always
apparent on inspection
and may be
asymptomatic
Possible cutaneous
manifestations include: a
skin depression or dimple,
dark tufts of hair, or port-
wine nevi
A visible, external, sac-like
protrusion on the lumbrosacral area
S/S vary based on the degree and
location of the spinal defect, and
can include:
Sensory impairment, partial
paralysis of the lower extremities,
overflow incontinence, lack of bowel
control, bladder and anal sphincter
paralysis, rectal prolapse, and
joint deformities
Demographics
Fecal continence can
often be restored with
proper nutrition (adequate
fiber intake), regular
bowel training, and
constipation prevention
50-70% of neural tube
defects could be
prevented with adequate
folic acid intake; thus, lack
of education and access
to quality, fortified foods
greatly increase the risk
of giving birth to a child
with spina bifida
Surgical closure of the sac is
recommended within the first 24 hours to
prevent complications such as infection,
rupture, and trauma to the exposed tissue
Broad-spectrum antibiotics are
initiated early for infection prevention
Physical therapy may be necessary if
there are musculoskeletal deformities
Clean intermittent catheterization,
temporary urinary diversion, or
augmentation enterocystoplasty may be
required depending on the level of
bladder dysfunction
A genetic anomaly resulting
in a fissure in the spinal
column, leaving the meninges
and spinal cord exposed.
Spina bifida is a neural tube
defect that occurs during
embryonic development.