Question

the charge nurse tells you that you will be admitting a 1 hour old infant , baby girl R , to to the neonatal intensive care unit with a myleomeningocele that was discovered in utero . what is the rationale for doing a ceasarean delivery for babies with myelomenongocele?

Answer 1

Myelomeningocele is the most common form of the spina bifida, in which the spinal cord and the tissue around the cord (meninges) protrude from the baby’s back and are contained in a fluid filled sac. There is no skin covering the defect. This type of defect happens in about 1 in every 1,000 pregnancies. Taking folic acid (vitamin B9) before pregnancy has reduced the frequency of this birth defect.

Management of pregnancy

Regular ultrasounds are used to monitor the baby’s overall growth and well-being. These are scheduled every few weeks as the pregnancy progresses. Other antenatal testing may be needed if there other findings or for obstetrical reasons. Delivery is usually planned around 39 or 40 weeks.

Delivery of a baby with myelomeningocele

The delivery of a baby with any type of spina bifida should be at a hospital that is prepared for high-risk births, including immediate access to a neonatal intensive care unit and pediatric surgical services. This will simplify communication between obstetrical, neonatal and pediatric surgical teams as well as limit the separation between mother and baby.

The method of delivery for babies with a myelomeningocele remains under debate. There is no clear evidence that having a Cesarean section will improve the outcome of these babies. However, a C-section may be needed for an obstetrical reason, such as for a baby with very large ventricles who has an increased head circumference.

Thus

Myelomeningocele is basically a defect of the spine and the spinal cord. It is observed before the birth that the spine of the baby, spinal and spinal canal does not join or close normally. The delivery of the baby with this kind of condition should be done at the hospital wherein the hospital is prepared for high-risk births which include quick access to neonatal intensive care and pediatric services.

The procedure of delivery for such babies are known to be C-section because a part of the spinal cord is lies outside the body, it is safe to avoid any kind of trauma to the site of the infection to that region during the birthing process.