Myelomeningocele: a Brazilian University Hospital experience
Maria M M Ulsenheimer1, Sérgio A Antoniuk, Lúcia H C Dos Santos
1Departamento de Pediatria, Universidade Federal do Paraná, Curitiba, PR, Brazil.
Insights
This study followed 31 children with myelomeningocele, finding common issues like hydrocephalus and developmental delays. A multidisciplinary approach appears crucial for improving the quality of life for these patients.
Area of Science:
- Pediatrics
- Neurology
- Developmental Biology
Background:
- Myelomeningocele is a complex congenital condition requiring long-term management.
- Understanding the outcomes and challenges in affected children is vital for clinical practice.
Purpose of the Study:
- To analyze the clinical characteristics, management, and outcomes of children diagnosed with myelomeningocele.
- To identify common comorbidities and developmental trajectories in this cohort.
Main Methods:
- Retrospective analysis of 31 children with myelomeningocele born between 1990 and 2000.
- Data collection included prenatal diagnosis, delivery details, surgical interventions, comorbidities, and developmental assessments (Denver II test).
Main Results:
- Lumbosacral lesions were most frequent (46%). Hydrocephalus affected 30 patients, with 27 requiring shunts; shunted patients had higher meningitis rates.
- Significant delays in gross motor development were observed. Common comorbidities included neurogenic bladder (12 patients) and congenital clubfoot (53%).
- Seven patients (19.4%) developed epilepsy. Six infants died during the study period.
Conclusions:
- Myelomeningocele presents significant challenges including high rates of hydrocephalus, developmental delays, and orthopedic issues.
- A multidisciplinary approach is likely beneficial for enhancing the quality of life for children with myelomeningocele.
Abstract:
We analyzed 31 children with myelomeningocele born between July 1990 and July 2000. Follow-up median was 24 months (6-68 months). Only 2 mothers had a known etiologic factor (diabetes mellitus). Twelve had the correct prenatal diagnosis. All children were born at term; 23 by cesarean; 13 had rupture of the membrane. Surgical correction had a 4 days median (1 to 44 days). Lumbosacral lesions were the most frequent (46%). Thirty patients were hydrocephalic, shunt was placed in 27. Meningitis was 4 times more frequent in shunted patients. Seven became epileptic (19.4%). Denver II test showed significant delay in gross motor development. Neurogenic bladder was diagnosed in 12 patients. Congenital clubfoot was the main orthopedic malformation (53%). Six infants died. Nowadays, 17 patients are being followed. A multidisciplinary approach probably helps for a better quality of life.
