“Demographic profile and outcome of meningomyelocele in government medical college of Western UP”

Introduction: Meningomyelocele is a birth defect in which the backbone and spinal canal do not close before birth. Neural tube defects are one of the most common congenital malformations affecting the brain and spinal cord & Meningomyelocele is one of the commonest neural tube closure defects. The global prevalence of Meningomyelocele has been reported to be 0.8–1 per 1,000 live births. Hydrocephalus may affect as many as 80% of children with Meningomyelocele. The use of periconceptional folic acid supplements, prevents ~50–75% of cases of neural tube defects. This study aims to evaluate demographic and clinical profile, associated anomalies & outcome of children with Meningomyelocele. Materials and Methods: 113 patients with Meningomyelocele admitted to SVBP hospital, Meerut between Sept'16 to Aug'17, were analyzed prospectively. The data regarding demographic and clinical profile with associated congenital anomalies were obtained by questionnaire- interview with the parents and patients themselves. MRI was the essential investigation in all patients. The data was analyzed by SPSS 21.0 version. Results: Mean age of presentation is 9.1 months. M:F ratio is 1.1:1. Lumbosacral region is involved in 73.5% patients. Hydrocephalus was the most common (64.6%) associated anomaly. In 92% cases there is no history of folic acid supplementation & all patients were from low socioeconomic status. Excision & repair of Meningmyelocele is the most commonly (51.3%) performed surgery while surgical site infection is the most common (19.5%) complication. In our study (91.2%, n=103) patients improved & discharged, 2.7% (n=3) patients expired, 4.4% (n=5) patients left against medical advice while 1.8% (n=2) patients referred to higher centre due to various reasons. Conclusion: Low socioeconomic status & no maternal supplementation of folic acid are the important risk factors for the development of Meningomyelocele. Timely intervention with excision and repair gives good result. Modified rhomboid flap can be use to cover large defects.