Objective: We aimed to evaluate the clinical features, short-term prognosis, and effect of operation time on mortality and morbidity in neonates with meningomyelocele. Methods: This prospective study was conducted between January 2006 and December 2008. Clinical features, defective area, existence of additional anomalies, operation time, and morbidity and mortality data were recorded. The effectof operation time on mortality and morbidity was evaluated. Results: Patients (n = 28) were assessed during the study period. Mean birth weight, height, and head circumference were found to be 3,160 ± 582 g, 46.2 ± 3.3 cm, and 36.7 ± 4.1 cm, respectively. None of the mothers received folate supplementation. Hydrocephaly (n = 13), pes equinovarus (n = 4), pelvicalyceal ectasia (n = 4), acetabular dysplasia (n = 2), Chiari II malformation (n = 2), and hydronephrosis (n = 2) accounted for additional anomalies. The mean postnatal age for surgical operation was 3.2 ± 2.8 days; mean length of hospital stay was 10.2 ± 9.7 days. The cases operated after 72 h were hospitalized longer, received antibiotherapies for a longer duration and had higher total complication rates (p = 0.04, 0.02, and 0.01, respectively). Conclusion: Surgical operation of patients with meningomyelocele within 72 h after delivery significantly reduces not only the duration of hospitalization and antibiotic usage, but also complication rates.

1.
Robert HA: Congenital anomalies of the central nervous system; in Behrman RM, Arvin AM (eds): Nelson Textbook of Pediatrics, ed 16. Philadelphia, Saunders, 2000, pp 1803–1813.
2.
Rowland CA, Correa A, Cragan JD, Alverson CJ: Are encephaloceles neural tube defects? Pediatrics 2006;118:916–923.
3.
Back SA: Congenital malformations of the central nervous system; in Taeusch HW, Ballard RA, Gleason CA (eds): Avery’s Diseases of the Newborn, ed 8. Philadelphia, Elsevier, 2005, pp 938–959.
4.
Frey L, Hauser WA: Epidemiology of neural tube defects. Epilepsia 2003;44:4–13.
5.
Martínez de Villarreal LE, Arredondo P, Hernández R, Villarreal JZ: Weekly administration of folic acid and epidemiology of neural tube defects. Matern Child Health J 2006;10:397–401.
6.
Yerby MS: Management issues for women with epilepsy: neural tube defects and folic acid supplementation. Neurology 2003;61:23–26.
7.
Essien FB, Wannberg SL: Methionine but not folinic acid or vitamin B-12 alters the frequency of neural tube defects in Axd mutant mice. J Nutr 1993;123:27–34.
8.
Hambidge M, Hackshaw A, Wald N: Neural tube defects and serum zinc status. Br J Obstet Gynaecol 1993;100:746–749.
9.
Zeyrek D, Soran M, Cakmak A, Kocyigit A, Iscan A: Serum copper and zinc levels in mothers and cord blood of their newborn infants with neural tube defects: a case-control study. Indian Pediatr 2009;46:675–680.
10.
Bowman RM, Boshnjaku V, McLone DG: The changing incidence of myelomeningocele and its impact on pediatric neurosurgery: a review from the Children’s Memorial Hospital. Childs Nerv Syst 2009;25:801–806.
11.
Crowe CA, Heuther CA, Oppenheimer SG, Barth LD, Jeffrey E, Reinhart S: The epidemiology of spina bifida in south-western Ohio – 1970–1979. Dev Med Child Neurol 1985;27:176–182.
12.
Czeizel AE, Dudás I: Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med 1992;327:1832–1835.
13.
De Wals P, Tairou F, Van Allen MI, et al: Reduction in neural-tube defects after folic acid fortification in Canada. N Engl J Med 2007;357:135–142.
14.
Onrat ST, Seyman H, Konuk M: Incidence of neural tube defects in Afyonkarahisar, Western Turkey. Genet Mol Res 2009;8:154–161.
15.
Tunçbilek E, Boduroğlu K, Alikaşifoğlu M: Neural tube defects in Turkey: prevalence, distribution and risk factors. Turk J Pediatr 1999;41:299–300.
16.
Canfield MA, Ramadhani TA, Shaw GM, Carmichael SL, Waller DK, Mosley BS, et al: The National Birth Defects Prevention Study. Anencephaly and spina bifida among Hispanics: maternal, sociodemographic, and acculturation factors in the National Birth Defects Prevention Study. Birth Defects Res A Clin Mol Teratol 2009;85:637–646.
17.
Caldarelli M, Di Rocco C: Myelomeningocele primary repair surgical technique; in Ozek MM, Cinalli G, Maixner WJ (eds): Spina Bifida: Management and Outcome. Milan, Springer, 2008, pp 143–155.
18.
Oktem IS, Menkü A, Ozdemir A: When should ventriculoperitoneal shunt placement be performed in cases with myelomeningocele and hydrocephalus? Turk Neurosurg 2008;18:387–391.
19.
Hunt GM, Holmes AE: Some factors relating to intelligence in treated children with spina bifida cystica. Dev Med Child Neurol Suppl 1975;35:65–70.
20.
Idowu OE, Apemiye RA: Outcome of myelomeningocoele repair in sub-Saharan Africa: the Nigerian experience. Acta Neurochir (Wien) 2008;150:911–913.
21.
McLone DG: Continuing concepts in the management of spina bifida. Pediatr Neurosurg 1992;18:254–256.
22.
Stein SC, Schut J, Ames MD: Selection of early treatment of myelomeningocele: a retrospective analysis of selection procedures. Dev Med Child Neurol 1975;17:311–319.
23.
Bowman RM, McLone DG: Neurosurgical management of spina bifida: research issues. Dev Disabil Res Rev 2010;16:82–87.
24.
Koszutski T, Kawalski H, Kudela G, Wróblewska J, Byrka-Owczarek K, Bohosiewicz J: Babies with myelomeningocele in Poland: parents’ attitudes on fetal surgery versus termination of pregnancy. Childs Nerv Syst 2009;25:207–210.
25.
Pinar H, Tatevosyants N, Singer DB: Central nervous system malformations in a perinatal/neonatal autopsy series. Pediatr Dev Pathol 1998;1:42–48.
26.
Del Gado R, Perrone L, Del Gaizo D, Sommantico M, Polidori G, Cioce F, et al: Renal size and function in patients with neuropathic bladder due to myelomeningocele: the role of growth hormone. J Urol 2003;170:1960–1961.
27.
Elliott SP, Villar R, Duncan B: Bacteriuria management and urological evaluation of patients with spina bifida and neurogenic bladder: a multicenter survey. J Urol 2005;173:217–220.
28.
Isık U: Seizures in children with myelomeningocele; in Ozek MM, Cinalli G, Maixner WJ (eds): Spina Bifida: Management and Outcome. Milan, Springer, 2008, pp 297–301.
29.
Ozek E, Soll RF: Postoperative care of the newborn with myelomeningocele; in Ozek MM, Cinalli G, Maixner WJ (eds): Spina Bifida: Management and Outcome. Milan, Springer, 2008, pp 169–176.
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