Patterns and Short Term Neurosurgical Treatment outcome of Neonates with Neural Tube Defects Admitted to Felege Hiwot Specialized Hospital January 1st – December,30th 2018, Bahir Dar, Ethiopia

Yohannes, Addisu

dc.contributor.author	Yohannes, Addisu
dc.date.accessioned	2022-05-28T08:21:50Z
dc.date.available	2022-05-28T08:21:50Z
dc.date.issued	2019-11
dc.identifier.uri	http://ir.bdu.edu.et/handle/123456789/13718
dc.description.abstract	Background: Neural tube defects (NTDs) account for the largest proportion of congenital anomalies of the CNS and result from failure of the neural tube to close spontaneously between the 3rd and 4th weeks of in utero development. The major NTDs include spina bifida occulta, meningocele, myelomeningocele, encephalocele, anencephaly. Anecephaly is life incompatible. With improved perinatal, neonatal and neurosurgical care the early mortality associated with neural tube defects has reduced, the majority of children born with these defects had survived. Prognosis depends on the nature and the pattern of the defect. The nature of treatment outcomes and its pattern associated with grave prognosis is not well known. Objective: The aim of study was to determine the patterns and short term neurosurgical management outcome of newborns with neural tube defects admitted at FHSH. Methods: It was hospital based cross-sectional study on neonates who were admitted at FHSH with neural tube defects from January 1st - December,30th 2018 G.C. The study was included all neonates who presented with clinical and imaging diagnosis of myelomengocele, Encephalocele, meningiocele and other types of neural tube defects. The ultrasound findings were cross checked with WHO morphologic diagnostic criteria of neural tube defects. All Charts of Neonates with confirmed diagnosis of neural tube defects who were born at FHSH as well as patients referred from any other medical center or hospital in the study paired were reviewed as part of the study. Those who had incomplete documentation were excluded. Trained data collectors (medical interns) were being supervised by trained supervisors (general practitioners) participated in the data collection process by using data extraction format. Result: Among the total NICU visits, 136 patients were clinically diagnosed to have NTDs. Of these, 109 patients had complete documentation and imaging confirmed neural tube defects. Sixty-seven (61.5 %) newborns from those who diagnosed to have NTD were males and forty-two (38.5%) were females. The male to female ratio was 1.59 :1. Visible sac (swelling) on the back was the commonest presentation of all NTD patients existing in 47% of all NTD cases. Myelomeningocele was the commonest pattern of NTDs accounting 64.2% followed by meningiocele and encephalocele accounting 23.9% and 11.9% respectively. Thoracolumbar spine was the commonest site of presentation accounting 45%, followed by lumbar area 34.9%. Fifty-one (46.8%) of neonates were having isolated neural tube defects. The most common associated impairment was hydrocephalus 33.9%. forty-five (41.3%) of 109 neonates with NTDS were having multiple complications after surgery followed by meningitis and hydrocephalus accounting 14.7% and 11.9% respectively. The mortality rate was 7.3%, 44% were discharged with squeale and while 36.7% were discharged without impairment. The most common causes of death were infection 66.7% and Chiari crisis 33.3%. Conclusion: Myelomeningocele was the most frequent clinical pattern of neural tube defect and thoracolumbar spine was the commonest site. Hydrocephalus was seen in cases before surgery. Isolated neural tube defect was the commonest finding accounting followed by NTDS with hydrocephalus. There were multiple complications (two and above) after surgery followed by meningitis and hydrocephalus respectively. The mortality was 7.3%, the most common causes of death were infection and Chiari crisis. Long term follow-up is needed regardless of initial surgical intervention to know the subsequent outcome and, requires early and appropriate diagnosis and treatment. A multidisciplinary approach is required to address this disease. Key words: pattern, neural tube defects, outcome, neonates, Felege Hiwot Hospital	en_US
dc.language.iso	en	en_US
dc.subject	Pediatrics and Child Health	en_US
dc.title	Patterns and Short Term Neurosurgical Treatment outcome of Neonates with Neural Tube Defects Admitted to Felege Hiwot Specialized Hospital January 1st – December,30th 2018, Bahir Dar, Ethiopia	en_US
dc.type	Thesis	en_US