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Neural Tube Defects (NTDs) - Coggle Diagram
Neural Tube Defects (NTDs)
Pathophysiology
Neural tube defects occur due to failure of neural tube closure during early embryonic development
Occurs between day 22–28 of gestation
The neural tube develops into the brain and spinal cord
Failure of closure leads to exposed neural tissue
Causes abnormal development of the central nervous system
Results in neurological damage, disability, or death
Folic acid is essential for DNA synthesis and cell division during neurulation
Deficiency increases the risk of neural tube defects
Types of Foot Ulcer
Open Neural Tube Defects
Neural tissue is exposed
More severe
Examples:
Spina bifida (myelomeningocele)
Meningocele
Anencephaly
Closed Neural Tube Defects
Skin covers the defect
Less severe
Examples:
Spina bifida occulta
Lipomyelomeningocele
Causes / Etiology
Folic acid deficiency
Genetic factors
Family history of neural tube defects
Maternal diabetes
Maternal obesity
Hyperthermia during pregnancy (fever, hot baths)
Poor maternal nutrition
Lack of prenatal care
Exposure to certain medications:
Valproic acid
Carbamazepine
Signs and Symptoms
Weakness or paralysis of lower limbs
Loss of bladder control
Loss of bowel control
Hydrocephalus
Difficulty walking
Developmental delay
Sac-like swelling on the back
Visible spinal defect
Abnormal head size
Learning difficulties
Risk Factors
Previous baby with neural tube defect
Folic acid deficiency
Maternal diabetes
Maternal obesity
Poor nutrition
Low socioeconomic status
Lack of antenatal care
Exposure to teratogenic drugs
Genetic predisposition
Procedures
Prenatal Procedures
Ultrasound
Maternal serum alpha-fetoprotein (AFP) screening
Amniocentesis
Postnatal Procedures
Physical examination
MRI
CT scan
Neurological assessment
Treatment / Drugs
Preventive
Folic acid supplementation before conception and during early pregnancy
Medical
Antibiotics if infection occurs
Pain management
Surgical
Surgical closure of spinal defect
Ventriculoperitoneal (VP) shunt for hydrocephalus
Supportive
Physiotherapy
Occupational therapy
Mobility aids
Nursing Interventions
Protect exposed neural tissue
Prevent infection
Monitor neurological status
Maintain skin integrity
Position infant carefully
Assist with feeding
Monitor bladder and bowel function
Educate parents about condition
Provide emotional support
Labs and Diagnostic Tests
Prenatal
Maternal serum AFP
Amniotic fluid AFP
Ultrasound
Postnatal
MRI
CT scan
Neurological examination
Complications
Paralysis
Hydrocephalus
Learning disabilities
Bladder dysfunction
Bowel dysfunction
Recurrent urinary tract infections
Mobility impairment
Pressure sores
Death (in severe cases such as anencephaly)