To Document The Clinical Presentation and Outcome of Open Neural Tube Defect at Teaching Hospital, Dera Ghazi Khan

  • IQBAL AHMAD Department of Neurosurgery, D.G. Khan Medical College & Hospital, Dera Ghazi Khan
  • MALIK LIAQAT ALI JALAL Department of Neurosurgery, D.G. Khan Medical College & Hospital, Dera Ghazi Khan
  • TEHMINA NAWAZ Department of Neurosurgery, D.G. Khan Medical College & Hospital, Dera Ghazi Khan
  • SAMIA SAEED Department of Neurosurgery, D.G. Khan Medical College & Hospital, Dera Ghazi Khan
Keywords: Meningocele, Spina Bifida, Myelomeningocele


Objectives: To study clinical presentation and to determine outcome of open Neural Tube Defects at our
respected institution. We took a review of all cases of open neural tube defects seen at the Neurosurgery Unit of hospital in the last years to document their medical patterns, assess their neonatal outcome.
Materials and Methods: This retrospective study included 74 patients, admitted to the Department of
Neurosurgery, D. G. Khan Medical College and Hospital, Dera Ghazi Khan. The procedure for history taking
and clinical examination was completed to measure Folic Acid Intake in first trimester, ultra sound abdomen,
pre-natal diagnosis, hydrocephalous, CSF leak from swelling, sphincter involvement, weakness of lower limb,
previous baby affected, type & location of open neural tube defects along the cranio-vertebral axis. Spine X-rays,neurosonograms, MRIs were carried out to find associated irregularities and complications if exist.
Results: Out of 74 children born with open neural tube defects, 9 (12%) mothers received antenatal care only, 7
(9%) get folic acid regularly. Prenatal diagnosis was made in 11 (14.8%) mothers whose antenatal abdominal
ultrasound was done. The most common type of myelomeningocele was lumbosacral 58 (79%). Forty-four
(59.4%) babies have hydrocephalous while five babies were microcephaly. Increased risk of ruptured
myelomeningocele was linked with vaginal delivery. Sphincter disturbance and limb paralysis was present in 35
(47%) and 32 (43.7%) of babies respectively. The mortality was in 12% patients.
Conclusion: We suggest that efforts should be made in this respect to prenatal diagnosis of such lesions to get
better neonatal outcome


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Original Article