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Causes of death in 31 newborn infants with myelomeningoceles
Insights
Mortality in premature infants with myelomeningocele is high, especially in those with uncovered defects or associated conditions. Key factors influencing survival include maturity, presence of other malformations, and membrane coverage of the myelomeningocele.
Area of Science:
- Neonatalogy
- Pediatric Surgery
- Developmental Biology
Background:
- Myelomeningocele is a severe congenital condition impacting newborns.
- Premature infants with myelomeningocele face significant mortality risks.
Purpose of the Study:
- To identify key factors contributing to mortality in premature infants diagnosed with myelomeningocele.
- To analyze the relationship between myelomeningocele characteristics and infant survival rates.
Main Methods:
- Retrospective analysis of case material involving premature infants with myelomeningocele.
- Evaluation of clinical condition, associated malformations, and myelomeningocele membrane status.
Main Results:
- Eight out of ten premature infants died within the first ten days.
- Infection was a primary cause of death in seven infants.
- Meningitis, often E. coli-related, occurred in five infants; 75% of all infants died within the first week.
Conclusions:
- Infant survival with myelomeningocele is critically dependent on gestational maturity.
- Associated malformations significantly increase mortality risk.
- The presence or absence of a membrane covering the myelomeningocele is a crucial prognostic indicator.
Abstract:
Eight of the ten premature infants died during the first ten days. Six of these were in poor general condition with cyanosis, respiratory distress or aspiration of amniotic fluid. One child died after a fit before he was operated upon for his myelomeningocele. Ventricular haemorrhages were found in two premature infants. Seven of the premature infants died of an infection. In 23 infants the myelomeningocele was not covered by a membrane. Approximately 75% of the infants, i.e. 15, died during the first week of life. A meningitis was found in five infants; in four cases it was due to E. coliand in one, due to klebsiella. It, therefore, appears from studying our case material that deaths in newborn infants with myelomeningocele depends on the following facts: 1) maturity, 2) associated malformations, 3) whether the myelomeningocele is covered by a membrane or not.