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Pattern of neural tube fusion defects in Sudan
Nugud A, Arbab M, Osman TM. Faculty of Medicine, University of Gezira, Wad Medani.
Saudi Med J. 2003 May;24:S54 Objectives: To study the overall pattern of neural tube fusion defects (NTFD), their season variation, to access folic acid supplementation in antenatal care prophylaxis against NTFD, to determine maternal risk factors, and the anomalies commonly associated with this problem and to optimize screening for selected groups of mothers at risk. Methods: This retrospective study included 43 patients admitted to Khartoum Neurosurgical Unit and Wad Medani Childrens Hospital (the 2 major centers in Sudan). Data collected included age, sex, maternal risk factors, clinical assessment and maternal screening. Results: There was no significant difference in male and female ration. 20.9% of patients were born in February, 11.6% in March and 9% in Jan, 21.7% of mothers received folic acid in early pregnancy and non preconceptually. Maternal diabetes was reported in 9% of cases. Regarding parity of mothers among the studied population, 60.5% are first or second born children, 67.4% from rural areas and 32.6% urban areas. The sib recurrence rate is 7.0%. The pattern of defect shows, 4.6% spina bifida occulta, 90.8% cystica and the latter shows 11.6% meningoceles and 88.4% myelomeningocele, 4.6% encephalocele and no anencephaly. Associated anomalies include 34.9% club foot, 23.3% hydrocephalus, 2.3% facial clefts, and 2.3% polycystic kidneys. Tribal distribution 83.7% from Arab tribes and 16.3% from Negro tribes. Conclusion: The study concluded high incidence of NTFD during winter and in the 1st born child. Club foot and hydrocephalous are the most common associated anomalies. Maternal risk factors are diabetes, low parity and folic acid deprivation preconceptually, and it is also noticed that folic acid is prescribed to meet the maternal and fetal needs during pregnancy and not as prophylaxis against NTFD.
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