Clinical Manifestation and Initial Management of Newborn with Spina Bifida Aperta: a case report.
Indra Sandinirwan
1* , Wargian Hadisaputra
21 Department of Pediatrics, Hermina Hospital Sukabumi
2 Department of Neurosurgery, Hermina Hospital Sukabumi
Abstract
Spina bifida is a birth defect that occurs due to the disruption of the formation of the neural tube with an incidence of 1–10 cases per 1000 live births. Spina bifida can appear as an occulta or aperta type, and the latter consists of meningocele, myelomeningocele, and myeloschisis. We reported a case of a term male newborn who was presented with lethargic, bradypnea, suction reflex abnormalities, and paralysis of lower extremities. A defect was found in the spine in the thoracolumbar region showed a placode with no meningeal and skin covering, suggestive of a myeloshisis. The patient was treated in the neonatal intensive care unit, was placed on non-invasive ventilation with successful weaning, parenteral nutrition, systemic antibiotics regimen, and wound care. The patient was consulted with a neurosurgeon and was subjected to an ultrasound examination of the head that led to hydrocephalus. After experienced clinical improvement and oral tolerance, the patient was allowed for discharged and scheduled for surgery.