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  • Yesterday, Pinoy Big Brother alum Wendy Valdez and husband Norman Garcia took to Instagram to ask for prayers for their first baby. He needed surgery to remove a cyst located at the bottom of his spine. According to her posts, their son Seth had spina bifida. 

    Thankfully, the surgery was a success. Wendy could now hold her baby in her arms and even sucessfully breastfeed him. However, many were curious about Seth's condition. Here are the basics of what you need to know about spina bifida: 

    What is it?
    Spina bifida, which literally means "split spine," is a neural tube defect wherein the baby's spinal column did not fully close. It usually happens towards the end of the pregnancy's first month, often when women don't even know they're pregnant. 

    What causes it?
    The cause of spina bifida is currently unknown, so there is no guaranteed way to prevent it. According to the Spina Bifida Association (SBA), doctors and scientists believe genetic and environmental factors may play a role in causing the condition. The American Pregnancy Association also sites some conditions that may increase the risk of a mother giving birth to a baby with spina bifida. 

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    study published in the journal Pediatrics shows that pregnant women who took folic acid at least one month before getting pregnant and throughout the first trimester could reduce the risk of the baby developing the condition by 50 percent. However, while taking folic acid is crucial, it does not altogether prevent spina bifida.  

    Folate can also be consumed by eating green vegetables, fruits and juices, and some folic-acid fortified cereal and bread, but supplements ensure that you get enough of the vitamin for your unborn baby's healthy development. Pregnant women need about 400 mcg (0.4 mg) of folic acid, a synthetic form of the B vitamin folate. Those with a family history of spina bifida needs 4000 mcg (4 mg) of folic acid every day.  

    What are the types of spina bifida?
    Spina bifida occulta, also called "hidden spina bifida," is the mildest form of the condition. About 15 percent of children who have it would not be aware that they have it because there are no visible signs or symptoms; their nerves are usually intact. Their spinal cord may be attached to surrounding tissue instead of floating loosely in the spinal column and may cause some pain but they often go on to live full lives. 

    Spina bifida aperta (aperta means "open" in Latin) has two subtypes: meningocele and myelomeningocele.

    Meningocele causes part of the spinal cord to come through the spine like a sac filled with nerve fluids that is pushed out. It could be as small as a grape or as large as a grapefruit, usually covered by a thin layer of skin. It could be located anywhere along the spinal column: the baby's head, neck, or back. However, there is usually no nerve damage but may have minor disabilities.

    Babies with this kind of spina bifida may have health issues, such as bowel and bladder control and muscle paralysis if their nerves are damaged. The extent of their paralysis depends on where the meninges (membranes that cover and protect the brain and spinal cord) is located along the spine. "The higher the opening is on the back, the more severe the paralysis can be," according to KidsHealth.  

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    Myelomeningocele, on the other hand, is the most severe form of spina bifida, wherein parts of the spinal cord and nerves are protruding through an open part of the spine. This could cause more nerve damage and other disabilities such as muscle and bone problems and paralysis. 

    Most babies who have this condition accumulate too much fluid in the brain. They may also be diagnosed with hydrocephalus (a condition wherein there is too much fluid in the brain) because  their spinal cord is unable to drain it as it should. The fluid build-up causes pressure and swelling, which results in brain damage if left untreated.

    According to the SBA, there's another type, occult spinal dysraphism (OSD), where the baby has a dimple in their lower back. Not all babies who have dimples have OSD, though, so doctors need to check for other signs such as "red marks, hyperpigmented patches on the babies' back, tufts of hair or small lumps." When left untreated, the child's spinal cord may not grow which could cause serious problems. 

    How is it diagnosed?
    Spina bifida can be detected via three pregnancy tests: maternal serum test, ultrasound, and a fetal  MRI. 

    Maternal serum test, also known as the triple test or quad test, is a blood test that measures the levels of alpha-fetoprotein (AFP) in the mother's blood. Unusually high amounts of AFP in the mother's blood may indicate that the fetus has a neural tube defect. It doesn't specifically identify spina bifida, and so more test may be required. 

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    An ultrasound scan is routine for every pregnant woman and can also detect some signs of spina bifida in both the brain and spine. These markers include the abnormal shape of fetus's skull (lemon sign), crowding of the cerebellum in the back part of the head (the banana sign), hydrocephalus (having too much fluid in the brain, and broken or missing links in the fetus's spine. 

    Fetal MRI (magnetic resonance imaging) is used to determine the severity of spina bifida in an unborn baby after an ultrasound or maternal serum test. It shows better images of the spinal cord and nerves and helps doctors explain the diagnosis and expected long-term conditions for their baby. 

    How is it treated?
    Depending on the severity of the baby's spina bifida, surgery may be needed. For fetuses diagnosed earlier than 25 weeks into the pregnancy, fetal surgery in the womb is an option. Some babies undergo surgery within two to three days after birth.

    Some kids would need help from neurosurgeons, urologists, orthopedists, physical and occupational therapists, and psychologists, depending on the health issues due to spina bifida. Other children continue to live full lives without surgery. 

    Sources: Spina Bifida AssociationAmerican Pregnancy Association,KidsHealth, MSD Manual

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