Does risk of spina bifida merit ultrasound?

[mamayes]

I have a friend who just had a baby with spina bifida. The baby required two major surgeries right after birth. My friend also had a c-section because of the exposed spine. Is a c-section always necessary? She had her other baby at home UC, so I would think she really looked into all the risks.

Her experience makes me think twice about not having any ultrasounds the next go round for myself. Is there anything else prenatally that would have clued her care provider into the baby having spina bifida? It sounds like in her case it was a good thing she had the ultrasound and that the c/s was also probably needed. Thoughts?

[courtenay_e]

I have a 3mm separation in my C2. My neurosurgeon thinks it was probably caused by not quite enough folate during pregnancy. That said, he says that it could ALSO be genetic (though we have nobody in our family w/it to my knowledge), and that I should get the 20 wk scan.

I have a girlfriend with a son who had quite a serious one, who declined the scan at 20 weeks. Luckily, though his was quite large and included a lumbar opening with the spinal cord outside his body, it was also enclosed in a sac, and was blessedly undamaged during labor and birth, and he had surgeries that fixed it. He was a bit of a miracle...they didn't expect him to walk or use the toilet by himself, and he does both.

I think that, if you think you weren't getting enough folate, or have a genetic predisposition to spina bifida, then, by all means, get the scan. Otherwise, it is not that likely that it'll happen to begin with. IMO, one of the "problems" with pregnancy and birth in our culture is the CONSTANT fear that something will be wrong with the baby or birth...we're just not capable as a culture of enjoying our pregnancies.

That said, I respect the neurosurgeon who looked at my VERY small separation, and I get a brief scan to check for that, when I'm at around 20 weeks. Why tempt fate?

[Birth&Bunnies]

I think going to a Dr. that trusts birth makes a difference if you want to do some tests. (hard to fin) If I somehow ever get pregnant, I might get one scam. There are few things that would prevent me from a homebirth. Most have symptoms, spina bifida doesn't. It would be one of the few things I would have a c-sec for.

[Bellejar]

If you don't want an ultrasound, (just lurking here) There is a blood test called an AFP that can show if you are at high risk for spina bifida.

[courtenay_e]

She's right...but be aware, too, that the AFP is NOTORIOUSLY inaccurate in both directions. Freaks out mama after mama for no good reason (and even causes amnios that weren't necessary), and then misses the "real things," on top of it!

[Birth&Bunnies]

I second that. Depends what your goal is. If you want to avoid an ultrasound, then try a blood test first, but I think the ultrasound would be more accurate for spina bifida.

[pamamidwife]

well the unfortunate piece is that ultrasound will not identify many neural tube defects unless they're rather large. there are small openings in the spine that are not seen on ultrasound that could really affect a baby/child.

it's one example of the stock we put in ultrasound as a diagnostic tool.

if a woman really wants to know, I'd go right for the amnio. it's more accurate and not going to leave you guessing with ultrasound's vague screening.

[mamayes]

I've denied all the blood tests in the past because I think they're so inaccurate. But I'm thinking that an ultrasound would be able to detect the kind of severe case of spina bifida that would affect the baby during birth and warrant a c-section.