நரம்பியல் மற்றும் மருத்துவ ஆராய்ச்சி இதழ்

A Clinical Study of Spinal Dysraphism Cases in Tertialy Care Center, Kakinada, Andhra Pradesh

M Premjit Ray and Kodali Sandhya*

Background

We encounter cases of spinal dysraphism in our hospital very frequently. There is no documented evidence on the total number of population affected with Spinal Dysraphism available in our area .This prompted us to conduct the clinical study of spinal dysraphism cases in Rangaraya Medical College , Kakinada , Andhra Pradesh.

Introduction

In India, neural tube defects are the most common congential abnormality noted in every corner of the country in all communities. Most of the mothers are primi gravida with poor awareness of preconceptual supplementation. In our country inspite of regular government run programmes of mother & child care, we get to see these cases very often. There is lot of apprehension post birth of an abnormal child in the family.

Materials & Methods: This is a Prospective Longitudinal study. All patients with complaints of spinal dysraphism coming to the department of neurosurgery , GGH ,under Rangaraya medical college kakinada during the period of October 2015- December 2017 were included in the study after taking informed consent from parents/guardians. All patients were analysed as per our study protocol.

Results: A total number of 30 patients have been included in the study. Preconceptual folate usage only in 2 , Prenatal folate usage in all patients ,Premature delivery in 8, Age of presentation was less than 1 month in 46.6% , Female infants more affected , Lumbar region was the most common site of presentation , Total paraplegia in 46.6%, Surgical outcome – 4 had hydrocephalus , 7 had respiratory infections , 12 had wound infection ,5 mothers had one previous abortion, other anomalies detected are Tetralogy of Fallot in one and single kidney cyst in one baby. Conclusion: Spinal dysraphism cases were frequently seen in clinical practice in GGH, kakinada. Majority were from low socioeconomic group of rural background with less awareness of preconceptual folate usage .Mothers with previous miscarriages had NTD in present child birth. Spinal dysraphism management and prognosis depend on early diagnosis and prompt treatment at the earliest.