Vertebral column fails to close during intrauterine development
1. Spinal bifida occulta
Spina bifida occulta: Failure of vertebral arch to close, a dimple occurs on the sacral area, may be covered by a tuft of hair.
Meningocele: Protrusion of membranes of the meninges. Meninges consist of: dura mater, arachnoid, and pia mater) covered by thin membrane. No paralysis because spinal cord is not involved.
Myelomeningocele: Protrusion of the meninges and spinal cord. Covered by thin membrane, Extent of paralysis depends on the location of the defect. Results in hydrocephalus
Same day surgery: correct defect, minimize complications, and prevent infection, Encourage folic acid 4mg Po with future pregnacies (conception-6 weeks)
Primary intervention after birth of infant with meningocele,and myelomeningocele is to cover defect with a sterile, saline-soaked dressing
Encourage parents to become involved with infant care ASAP
Learn techniques: feeding, ROM exercises, positioning, catheterization, skin care,
•Potential for infection R/T presence of infective organisms, non-epitheliazed meringue sac, paralysis.
•Potential for trauma R/T delicate spinal lesion
•Potential impaired skin integrity R/T paralysis, continual dribbling of urine
•Potential for complications R/T impaired circulation of CSF or neuro-muscular impairment