Definition
Meningocele or also known as spina bifida (Latin: open spine) is a type of congenital developmental abnormalities. The process of this disorder usually occurs during the first four weeks of pregnancy and consisted of abnormal or incomplete closure of the neural tube (the future of the central nervous system).
Congenital anomalies are structural abnormalities in the baby's growth arising from the life of the products of conception egg. Congenital anomalies can be an important cause of abortion, stillbirth or death shortly after birth. Infant mortality in the first months of life is often caused by congenital abnormalities severe enough, it seemed to be a natural selection for survival of babies born. Babies born with major congenital abnormalities, generally will be born as low birth weight babies often even as a small baby to her pregnancy. Low birth weight infants with severe congenital abnormalities, approximately 20%
died within the first week of life. Besides physical examination, radiological and laboratory for diagnosis of congenital abnormalities after birth also known as the diagnosis of pre / - antenatal congenital anomalies with a certain number of ways such as ultrasound examination, examination of amniotic fluid and fetal blood.
Clinical symptoms Meningocele
Symptoms vary, depending on the severity of damage to the spinal cord and nerve roots are affected. Some children have mild symptoms or no symptoms, while others suffered paralysis in the area supplied by the spinal cord and nerve roots are affected.
There are several types of spina bifida:
1. Occult spina bifida: Spina bifida is the lightest. One or more vertebrae are not formed normally, but the spinal cord and membranes (meningens) is not prominent.
2. Meningokel: meningens vertebrae protruding through incomplete and palpable as a fluid-filled lumps under the skin.
3. Mielokel: the type of the most severe spina bifida, where the spinal cord protrude and overlying skin looked rough and red.
Symptoms include:
- Protrusion like a bag on the back of the middle to bottom of the newborn
- When illuminated, the bag is opaque
- Paralysis / weakness in the hips, legs or feet
- Decreased sensation
- Incontinence uri (beser) and fecal incontinence
- Spinal cord exposed susceptible to infection (meningitis).
Symptoms in spina bifida occult:
- Tuft of hair on the sacred area (the back of the pelvis)
- Grooves on the sacrum area.
Figures Genesis
Congenital abnormalities in newborns may be one type of disorder alone or can be in the form of multiple congenital abnormalities simultaneously as multiple congenital anomalies. Sometimes a congenital abnormality has not been found or not visible at the time the baby is born, but recently discovered some time after birth. In contrast with kermajuan medical technology, sometimes a congenital abnormality known during fetal life. If found one major congenital abnormalities in newborns, should alert the possibility of congenital abnormalities elsewhere. It is said that if we find two or more minor congenital anomalies, major congenital abnormalities ditetemukannya likely elsewhere at 15%, while if found three or more minor congenital anomalies, major congenital abnormalities chances by 90%.
The incidence of major congenital abnormalities ranging from 15/1000 births incidence rate would be 4-5% when the infants followed until the age of 1 year. Hospital Dr. Madura (I975-1979), the clinical incidence of congenital anomalies found as many as 225 babies between 19 832 live births or of 11.61 / 1,000 live births, while in the Hospital Dr. Pirngadi, Medan (1977-1980) of 48 infants (0.33%) among 14 504 births and at Gadjah Mada University Hospital (1974-1979) amounted to 1.64 of the 4625 birth of the baby. The incidence and types of congenital abnormalities can vary for different racial and ethnic groups, as well as can be depending on how the calculation keciInya congenital abnormalities.
Etiology Meningocele
The immediate cause of congenital abnormalities often hard to know. Embryonic and fetal growth is influenced by various factors such as genetic factors, environmental factors or both of these factors simultaneously.
Several etiologic factors that might impact on the occurrence of congenital anomalies among others:
1. Genetic and Chromosomal Abnormalities.
Genetic abnormalities in the father or mother is likely to have an influence on congenital abnormalities in children. Among these abnormalities exist that follow Mendel's law of plain, but it can also be inherited by the baby in question as the dominant element ("dominant traits") or sometimes as an element recessive. DaIam investigation it is often difficult, but the same congenital abnormalities in the offspring can help selanjutya steps. With the advances in medical technology, it has to be checked kemingkinan chromosomal abnormalities during fetal life, and have to consider further measures. Some examples of autosomal trisomy 21 chromosomal abnormalities as Down syndrome (mongolism). Abnormalities of the sex chromosome as turner syndrome.
2. Mechanical Factors
Mechanical stress on the fetus during intrauterine life can cause abnormal hentuk organs to cause deformity cersebut organ. Predisposing factors in the growth of the organ itself will facilitate the deformity of an organ.
3, the factor of infection.
Infections that can cause congenital abnormalities is infection that occurred in the period of organogenesis in the first trimester of pregnancy. The presence of certain infections during the period of organogenesis may cause an interruption in the growth of an organ collapse. Infection in the first trimesrer side can cause congenital abnormalities may also increase the likelihood of miscarriage. As an example of viral infection in the first trimester is oleb Rubella virus infection. Babies born to mothers who suffered from rubella infection in the first trimester may suffer from congenital abnormalities of the eye as cataracts, abnormalities in the auditory system as a deaf and discovery of congenital heart defects. Some other infections in the first trimester can cause congenital abnormalities such as viral infections is cytomegalovirus, toxoplasmosis infection, congenital abnormalities that may be encountered is the presence of growth disorders in the central nervous system such as hydrocephalus, Microcephaly, or microphthalmia.
4. Factors drug
Several types of specific drugs taken pregnant women in the first trimester of pregnancy is suspected is closely related with the occurrence of congenital abnormalities in the baby. One type of drug that has been known to cause congenital abnormalities Dagat is thalidomide that may result fokomelia or mikromelia. Some types of herbs that drunk young pregnant women with the aim of unfavorable allegedly also closely related to the occurrence of congenital anomalies, although this is not yet widely known laboratory for sure. Preferably during pregnancy, especially the first trimester, avoid the use of drugs that do not need it at all; although this is sometimes difficult to avoid because the mother was forced to take medication. This is for example the use of trankuilaiser for a particular disease, or the use of cytostatic hormonal prepaat unavoidable; circumstances should be considered as well as possible before pregnancy and the effect on the baby.
5. Maternal age factor
It is known that mongolism is more common in babies born to mothers who approach menopause. In the newborn ward Dr. Madura Hospital in 1975-1979, found the incidence of clinically mongolism 1.08 / 100 live births and found the relative risk of 26.93 for groups of women aged 35 years or over, a figure the state is found is 1:5500 for the group of mothers aged <35 years, 1:600 for the mother
aged 35-39 years, 1:75 to groups of women aged 40-44 years and 1:15 for groups of women aged 45 years or more.
6. Hormonal factors
Hormonal factors also thought to have links with the incidence of congenital abnormalities. Babies born to mothers with maternal hypothyroidism or diabetes mellitus is likely to experience greater growth disorders compared to normal infants.
7. Factors radiation
Radiation at the beginning kehamiIan likely to be able to cause congenital abnormalities in the fetus. A history of radiation that is large enough to be parents feared would lead to a mutation in the gene that may once can cause congenital abnormalities in infants whose birth to. Radiation for diagnostic or therapeutic purposes should be avoided during pregnancy, especially in early pregnancy.
8. Nutritional factors
In animal experiments, severe malnutrition during pregnancy can cause congenital abnormalities. In humans, the investigations showed that the frequency of congenital anomalies in infants born to mothers that lack of food is higher when compared to babies born to mothers with good nutrition. In animal experiments, protein deficiency, vitamin A ribofIavin, folic acid, thiamin and other Iain & elainan can increase the incidence of congenital.
9. Other factors
Many congenital abnormalities of unknown cause. Factors fetus itself and fetal environmental factors suspected to be a contributing factor. Social problems, hypoxia, hypothermia, or hyperthermia is suspected to be a contributing factor. Often the cause of the disorder kongenitai tidakdiketahui.
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