Posts Tagged ‘ spina bifida ’

In-Utero Surgeries More Common, Life-Changing

Thursday, July 24th, 2014

New methods of performing surgeries while babies are still inside their mothers’ wombs are becoming more common, in many cases greatly improving the quality of life of babies who are diagnosed with potentially serious conditions affecting the heart, bladder, larynx, and more.  One medical group in Mexico has successfully performed 200 such surgeries, and its doctors note that the new technologies and technique for what’s called “fetal medicine” are improving and becoming more widely available, parents need to be better educated about their medical options, especially if they are experiencing a high-risk pregnancy. More from ScienceDaily:

Although Mexico Fetal Medicine Group, located in Queretaro, has established itself as a cross reference for prenatal health in the country, Méndez González recognizes that there is a lack of prenatal drug culture among Mexican parents. “Generally the pregnancy situation is consulted to gynecologists, who are not necessarily specialists in fetal medicine. Lacking experience in this discipline, sometimes the detection of health problems is too late for the baby,” said the specialist at Fetal Medicine Mexico.

In the words of the medical specialist, consolidating a cross reference in fetal medicine in the country has positive effects such as the accumulation of knowledge and experience to practice and investigate medicine in unborn babies. Méndez González noted that the emergence of ultrasound changed the way people see pregnancy as the unborn baby began to be considered as a patient in need of its own care.

Last month, a new technology was announced that can perform in-utero surgeries, using a tiny robotic arm, on babies who are diagnosed with spina bifida, a condition which affects 1 in 2,500 babies worldwide.

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Nutrition May Make ‘Neural Tube’ Birth Defects More Common Among Hispanics

Monday, June 23rd, 2014

A set of birth defects of the brain and spine, called neural tube defects, have been found by a new study to be more common among babies with Hispanic mothers.  The March of Dimes report also found that Hispanic mothers are more likely to give birth prematurely–both findings are possibly linked to nutritional deficiencies more common to that community.

More from HealthDay News:

This report, updating a similar 2008 paper by the nonprofit foundation, also highlights the fact that a greater proportion of Hispanic women have babies each year than any other population in the United States, making it the fastest-growing ethnic group in the country.

“One of the things that caught our eye was, while Hispanics represent 17 percent of the population, 24 percent of premature babies are Hispanic,” said Dr. Edward McCabe, senior vice president and chief medical officer of the March of Dimes, an organization aimed at improving the health of mothers and babies.

Hispanic women may be more prone to giving birth prematurely — defined as before the 37th week of pregnancy — because of risk factors such as being three times as likely as white mothers to be younger than 17 years old. They are also less likely to have graduated from high school and more likely to lack health insurance. The rate of preterm births among Hispanics was about 12 percent higher than that of white mothers in 2012, the report said.

Neural tube defects, which include conditions such as spina bifida and anencephaly, are malformations of the brain and spinal cord that can cause death or disability.

Experts suggested that Hispanic mothers are significantly more likely to give birth to babies with these birth defects than white or black women because corn masa flour is a staple of the diet of a majority of Hispanics. Corn masa flour, used to make tortillas and other foods, is not fortified with folic acid, a B vitamin that can help prevent neural tube defects. Wheat flour manufacturers are required by the U.S. Food and Drug Administration to fortify that type of flour with folic acid, also called folate.

Also, Hispanic women are less likely to report taking a multivitamin containing folic acid prior to becoming pregnant, according to the report.

“This is why the March of Dimes is striving to have masa cornmeal fortified with folate,” said Dr. Diana Ramos, an associate clinical professor of obstetrics and gynecology at the University of Southern California Keck School of Medicine in Los Angeles.

“Corn masa flour is not part of the standard American diet, so, since 2012, we’ve been working on this, making progress slowly,” added Ramos, co-chair of the newly established March of Dimes Hispanic Advisory Council.

McCabe said the March of Dimes has launched a Spanish-language site, Nacersano.org, that offers information about the specific health needs of Hispanics. He said a variety of outreach efforts, including the website and new advisory council, are needed to help raise awareness in the Hispanic community about the need for folic acid consumption and prenatal health.

Image: Pregnant woman, via Shutterstock

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New Technology Could Allow Surgery on the Unborn

Thursday, June 19th, 2014

Some birth defects, including spina bifida, may soon become correctable conditions, if a new robotic technology that can perform surgery on a growing fetus comes to fruition.  The technology, which is a tiny robotic arm, is currently under development by British researchers, as CNN reports:

Spina bifida is one such disease, affecting approximately 1 in 2,500 newborns worldwide, where a lesion on the back leaves the spinal cord exposed in the womb, leading to severe disabilities, learning difficulties, and sometimes death.

The best option is to perform surgery to correct the problem before the baby is born but the complexities of such a procedure mean this currently only takes place in five countries worldwide. Most countries instead perform surgery after a child is born, but when the majority of damage has been done.

To reduce the risk involved in fetal surgery, scientists at University College London (UCL), and KU Leuven in Belgium are developing a miniscule robotic arm to enter the womb with minimum disruption to mother and baby. The robotics are targeting spina bifida but also lesser known conditions such as twin-twin transfusion syndrome, where blood passes unequally between twins who share a placenta, and fetal lower urinary tract obstruction, where babies are unable to urinate in the womb and their bladders become large and distended.

Surgery on fetuses has been effective in treating some conditions to date, but for spina bifida, the risks to mother and baby mean surgery is currently only performed in a handful of countries, where specialist teams exist.

“Most birth defects can be prevented if we can intervene earlier,” says Professor Sebastien Ourselin, from the UCL Center for Medical Image Computing, who is leading the new research project. “But currently, surgical delivery systems are not available and operating on babies in the womb is reserved for just a handful of the most severe defects as risks are too high.”

Feeling Baby Move: Weeks 18 to 21 of Pregnancy
Feeling Baby Move: Weeks 18 to 21 of Pregnancy
Feeling Baby Move: Weeks 18 to 21 of Pregnancy

Image: Fetus, via Shutterstock

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Birth Defects in Washington State Mystify Doctors

Monday, March 3rd, 2014

Doctors and public health officials are puzzled by why a cluster of diagnoses of anencephaly, a fatal birth defect in which infants are born missing parts of their brain and skull, has emerged in Washington state. The spate of diagnoses is leading parents and doctors to question how rigorous epidemiologists are being in determining the causes of the defect.  CNN has more:

For months, Andrea Jackman has been expecting a call from the Department of Health.

While pregnant, Jackman lived in the Yakima Valley, an agricultural area in south-central Washington. Her daughter, Olivia, was born in September with spina bifida, which, like anencephaly, is a neural tube defect the state is also tracking. Unlike anencephaly, however, spina bifida is usually not fatal.

She says she’s incredulous and outraged that state researchers haven’t called to ask questions: What did she eat while she was pregnant? Did she spend time near farms that sprayed pesticides? Did she take any herbs or supplements? How about Olivia’s father? Was he exposed to any toxic chemicals?

But no one has called.

Mandy Stahre, the state epidemiologist who’s investigating the cluster of birth defects, says it might be upsetting for mothers to get a call with such questions. Most of the women were pregnant with babies who had anencephaly, and the outcome is always horrible. If a woman didn’t miscarry, she had to make a decision whether to terminate her pregnancy or go ahead and have a baby sure to die soon after birth.

Stahre and her colleagues asked themselves: Would a phone call traumatize these women?

“We have to weigh that heavily. This is a devastating diagnosis, and we know that for a lot of these women they had to make some hard choices,” Stahre says. “We have to weigh how invasive we want to be with these types of interviews.”

Jackman says that attitude is paternalistic and condescending. She says she would do anything to help prevent another family from having a baby with a severe birth defect. State epidemiologists should have made those phone calls a long time ago, she says, since every day that passes, her memory, and those of other mothers, start to fade about what their habits were during pregnancy.

“What are you researching if you haven’t physically called the families to find out?” she asks.

‘Very bad research

Stahre has an answer to Jackman’s question: The state examined the mothers’ medical records, which revealed, among other things, the women’s home addresses.

By the address, epidemiologists can learn a mother’s water source, whether she lives near an agricultural area and whether she took folic acid early in pregnancy, which helps prevent neural tube defects.

“(Medical records) give us a lot of information about all of the known risk factors,” the epidemiologist says.

The state’s rigorous search of the women’s medical records, along with birth and death certificates, found nothing linking the families who had babies with birth defects.

That finding doesn’t surprise Dr. Beate Ritz, who’s done several studies on birth defects.

Ritz, vice chair of the epidemiology department at the UCLA Fielding School of Public Health, says medical records are notoriously unreliable: One doctor, for example, might note whether a woman smokes, but another doctor might not.

“From a research point of view, this is very bad research,” she says.

She says medical records reveal whether a woman has been prescribed any drugs, or diagnosed with a certain condition, but they don’t contain detailed information about a mother’s diet or possible toxins she might have been exposed to in the environment.

“The data quality on medical records is so low that it’s not really research,” she says.

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Study Examines Obesity Among Special-Needs Children

Thursday, November 3rd, 2011

Thirteen percent of American families include children with physical or developmental disabilities, but those families are left out of education and action campaigns around the obesity epidemic, a report from a special-needs advocacy group says.  The findings have led AbilityPath.org, an online resource and social community for parents and professionals serving the needs of adults and children with disabilities, to release a report called Finding Balance, with the goal of raising awareness of obesity among kids with autism, Down syndrome, and other disabilities, and offering tools to parents to help combat obesity in their families.

According to the Centers for Disease Control and Prevention (CDC), children with disabilities are 38% more likely to be obese than their counterparts.  “As a community, we must recognize the special dangers that obesity presents to our children,” says Sheryl Young, CEO of Abilitypath.org, “This is an epidemic in our own homes and we can and must find solutions.”

The report provides more startling statistics:

  • 67.1% of the teens with autism spectrum disorder were either overweight or obese.
  • 86.2% of the teens with Down syndrome were either overweight or obese.
  • 18.8% of the teens with cerebral palsy were either overweight or obese.
  • 83.1% of the teens with spina bifida were either overweight or obese.
  • 39.6% of the teens with intellectual disability were either overweight or obese.

Food aversions are common among special-needs children, among other reasons because medications often have appetite-altering side effects.  Mobility limitations also make it difficult for many children to be active enough to maintain a healthy weight. Increasing accessibility for play spaces, and including special-needs children in obesity studies and policy conversations are among the recommendation the report makes.

The report, which is in collaboration with Special Olympics and Best Buddies International, can be downloaded at the AbilityPath website.

(image via: http://stanfordmedicine.org/)

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