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 Anencephaly........

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مُساهمةموضوع: Anencephaly........   الثلاثاء 08 أبريل 2008, 22:29

Anencephaly:

Is known as a neural tube
defect. One of the most common occurring in about 1 out of every 1000
pregnancies. It is the failure of the neural tube to close properly resulting in
the absence of the major portion of the brain and the top part of the
skull



Neural Tube:
.*





The neural tube is a narrow sheath (see picture) that folds and
closes between the 3rd and 4th wks of pregnancy (roughly 21 to 28 days after
conception) to form the brain and spinal cord. When the cephalic or head end of
the tube fails to close properly, it results in the absence of the major portion
of the brain, skull and at times scalp. Infants are born without a fore-brain
(the thinking and coordinating area)and are usually blind, deaf, unconcious and
are unable to feel pain. Infants may exhibit reflex actions, such as respiration
and responses to touch and sound. ( I truly believe that even though my daughter
may have been deaf, that her soul...her spirit was not and that she was able to
hear and feel my love for her)




Diagnosis:


Diagnosis is usually made by the AFP
(alpha-fetoprotein) test at 16 to 18 wks and then confirmed by follow up level 2
ultrasound. Normally, a detectable and predictable amount of this protein
crosses the placenta and enters the bloodstream.The alpha-fetoprotein test
detects amounts of this protein, which is produced by the unborn babies liver,
and measures the amount in the mother's blood. But if the fetus has an abnormal
opening in its spine (spina bifida) or head (anencephaly), or an abdominal wall
defect, more alpha-fetoprotein may leak out which will cause the AFP test to be
elevated. Some cases of anencephaly have been diagnosed, via ultrasound, as
early as 10 1/2 wks . It has been shown that a transvaginal ultrasound is better
at diagnosing anencephaly before 16 wks than the standard abdominal
ultrasound



At
Risk:



Women taking anticonvulsant medication.

Women with
undiagnosed or uncontrolled diabetes.

Women with Malabsorption
problems.

Any woman with a family history of neural tube
defects.



Causes:



1) Folic acid defiency ( Which can be
caused by poor or inadequate diet,smoking, alcohol use, psorasis,&
birth-control pill use)

2) Undiagnosed diabetes

3) Hypervitaminosis A


4) High temperatures of 102 degress or higher for more than 5 hours. (Hot
tub use is discouraged when pregnant)

6) Anticonvulsant medication,
especially Valporic acid (valporate)

7) Environmental/chemical
exposure

Cool Rare genetic cause ( Genetics have long been considered likely
because of the increased risk of having a 2nd child with anencephaly, but
scientists still remain uncertain about the evidence to prove or disprove this
theory. Some genetic disorders such as waardenburg syndrome and certain ethnic
groups seem to have a higher incidence of anencephaly.)



Treatment:


There is no cure for
anencephaly.



Prognosis:



Most infants with anencephaly will be
born still. A small percentage(30-33%) will be born alive and will live for a
few moments to a few days. A rare few have lived for several
months.



Possible Complications:Polyhydraminos (increased amniotic
fluid) is caused by the poor swallowing reflex of the baby. With increased
amniotic fluid there is an increased chance of placental abruption if the water
breaks and comes out too fast. Generally, though, because there is no top part
of the head pressing down, the water does not break on its own. There is also an
increased chance of uterine rupture especially if there is a previous uterine
scar. Amniocentesis has been performed to remove some of the excess fluid in
some cases, but generally the polyhydraminos is just monitored through invasive
procedures such as ultrasound and fundal measurements. (In all the women I have
talked to who have had polyhydraminos, there was one who had placental
abruption, but she feels that is was the direct result of poor management by her
Dr. during labor.)


Prevention:



Taking 4 to 5 miligrams of folic
acid daily for 2 to 3 months before conception and until at least the 3rd month
of pregnancy is recommended for all woman at risk of having a child with a
neural tube defect.(Woman who have had a previous baby with anencephaly are 10
to 15 times more likely than average to have a second NTD pregnancy.Folic acid
is thought to be able to prevent 70% of NTDS.)Normal recommended daily dosage
for all woman of child bearing ages is 400 micrograms (0.4 miligrams).Taking
more than 1 miligram of folic acid daily is not recommended for all woman,
because folic acid can mask the symptoms of pernicious anemia (a B-12
deficiency) and makes diagnosis difficult.(To learn more about folic acid Click
Here.



Folic
Acid:




Folic acid is a necessary element needed for
correct neural tube development. It is part of the B-Complex Vitamins and is
also called folate or folacin. It is present in many leafy, green vegetables,
orange juice, dried beans, and peas. It is difficult to get enough folic acid by
diet alone. In fact, in order to get 4 mgs of folic acid daily, you would need
to drink 80 glasses of orange juice or have 100 servings of broccoli. In the
United States, we now fortify many of our grain products, such as bread to help
prevent neural tube defects. Folic Acid can significantly reduce the risk of
having a baby with a neural tube defect,but does not totally eliminate the
possibility







وهذا والله اعلم ما ارادة نفسي ان
تنوه عنه ومن لديه اي اضافه فاهلا ب
ه


_________________




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