Myelomeningocele (my-uh-lo-meh-NIN-guh-seal) is a type of spina bifida. Spina bifida (SPY-nuh BIF-ih-duh) happens when a baby's backbone (spine) does not form normally during pregnancy. The baby is born with a gap in the bones of the spine. Show
A myelomeningocele is a sac that contains:
It pushes through the gap in the spine and the skin. It can be seen on the baby's back. What Are the Signs & Symptoms of a Myelomeningocele?The signs and symptoms of a myelomeningocele depend on where it is. A myelomeningocele can lead to:
Sometimes babies with a myelomeningocele are born with other medical problems like clubfoot, curvature of the spine, hip problems, heart problems, or kidney problems. What Are the Other Types of Spina Bifida?Other kinds of spina bifida include:
What Causes a Myelomeningocele?All types of spina bifida happen in the first month of pregnancy. At first, a fetus' spinal cord is flat. It then closes into a tube called a neural tube. If this tube does not fully close, the baby is born with spina bifida. In myelomeningocele, a sac containing part of the spinal cord, meninges, and spinal fluid push through the gap in the spine and the skin. It's not clear why some babies get a myelomeningocele. It can happen if a woman does not get enough of the vitamin folic acid early in her pregnancy. A woman also might be more likely to have a baby with a myelomeningocele if she:
How Is Myelomeningocele Diagnosed?During pregnancy, a blood test called alpha-fetoprotein (AFP) can tell if a woman has a higher risk of having a baby with a myelomeningocele. A prenatal ultrasound or fetal MRI can show whether a baby has one. A myelomeningocele that's not diagnosed during pregnancy is seen when the baby is born. How Is Myelomeningocele Treated?After delivery, a baby born with a myelomeningocele will need:
Other medical care will depend on a child's needs. Treatments can include:
Some myelomeningoceles found before birth are treated with surgery while the baby is still in the womb. Sometimes this can lower the chances of the baby getting hydrocephalus later. And it might increase the strength of the child's legs. There are risks to the mom and baby from this surgery, so doctors and families have to decide together if the surgery is right for them. How Can Parents Help?Most children with myelomeningocele will need ongoing medical care. To help your child stay as healthy as possible:
Call your doctor right away if your child has:
Having a child with a serious medical condition can feel overwhelming for any family. But you're not alone, and many resources are available to help you and your family. Talk to anyone on the care team about ways to find support. You also can find more information online at: How should the nurse position a newborn who has a myelomeningocele?Since spina bifida occulta is often asymptomatic with minimal complications, surgery is typically indicated for meningocele and myelomeningocele. Infants with spina bifida should be placed in a prone position to prevent pressure on the lumbar sac.
Which position should the nurse place an infant after a surgical repair of a myelomeningocele to facilitate healing?Maintain the newborn in a prone position so that no pressure is placed on the sac; after surgery, continue this positioning until the surgical site is well healed.
What is the primary nursing intervention for an infant with myelomeningocele before surgical correction?Pre-operative management for myelomeningocele includes lesion stabilisation, positioning, infection control, prevention of latex sensitivity, monitoring of skin integrity, monitoring of respiratory function, management of neurogenic bladder and bowel, maintenance of thermoregulation and the provision of family support.
Which nursing action is most important in the care of a child with a myelomeningocele in the preoperative stage quizlet?What is important when caring for a child with myelomeningocele in the preoperative stage? Place the child on one side to decrease pressure on the spinal cord. Apply a heat lamp to facilitate drying and toughening of the sac.
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