Case Studies on Detection and Follow-up in NBBD network SWACH and NHM

Presentation

Male child was born at 40 weeks of gestation to a 25 year old mother out of consanguineous marriage. The baby was delivered at a tertiary hospital by normal vaginal delivery conducted by a doctor in Shahzadpur, Haryana. All anthropometric measures at the time of birth appeared to be normal, except the presence of a visible birth defect.

Description

The child had a large tumor in the lumbo sacral region, color of an eggplant with some whitish areas. It was intact. The head size was normal. There was no deformity of the lower limbs.

Verification

Photographs of the defect were submitted and full description was confirmed by WHO-SEARO to be:-

Q00-Q07 Congenital malformations of the nervous system

Q05.7 Lumbar spina bifida without hydrocephalus

It is a type of neural tube defect which in this case was found to isolated but visible at birth. The contents were most likely spinal cord or its coverings. This occurs if the fetal spinal column has not formed completely during the organogenesis in the first month of pregnancy.

There could be associated nerve damage that causes at least some paralysis of the legs in the future. Many children with spina bifida who go without treatment will need assistive devices such as braces, crutches or wheelchairs. They may have other difficulties, urinary and bowel problems

Treatment & Follow-up

In this child’s case, care of the baby in the form of exclusive breast feeding, careful handling of the tumor to prevent trauma and immunization was supervised by SWACH Play and communication was advised. The child was operated at the tertiary hospital at the age of 3 months. He made an uneventful recovery. The child is going to be 8 months age He is 8.5 kg weight He has been started on semi solid foods.