The Profile and Short-Term Outcome of Children with Myelomeningocele in Ilorin, North-Central Nigeria

A bstract Background: Myelomeningocele (MM) is a type of open spinal dysraphism that occurs in the early intrauterine life, around the third and fourth week of embryonic development when the mother is not even aware she is pregnant. Pre-conceptional folic acid supplementation has been found to reduce the incidence globally. Materials and Methods: This was a prospective cross-sectional study of children with MM, who were managed at the University of Ilorin Teaching Hospital over a period of 22 months. Forty-six children were recruited into the study, however, the parents of six of them departed against medical advice leaving 40 patients for analysis. All forty patients had an echocardiogram and trans-fontanel ultrasound done and underwent surgical repair of their MMs. Prenatal and post-natal data were collected, which was analyzed by Statistical Package for Social Sciences version 23. Results: There was a slight female preponderance with female to male ratio of 1.4:1. Majority (75%) of the mothers were between ages 21 and 30 years, with only 7.5% of them being above 35 years of age. While the majority (85%) of the mothers took post-conceptional folic acid which was commenced at antenatal registration, only 5% of them took pre-conceptional folic acid. The lumbosacral region was the commonest location of MM in this series, accounting for 95% while the thoracic region accounted for the remaining 5%. The most common associated congenital anomaly was hydrocephalus (65%). Surgical site infection (SSI) was the commonest post-operative complication (17.5%), others were cerebrospinal fluid leakage (10%), wound dehiscence (5%), and pseudomeningocele (5%), 5% of the patients had combined SSI and wound dehiscence. Conclusion: The majority of the mothers of children with MMs in this setting did not take pre-conceptional folic acid which is a preventive measure against this malformation. The commonest associated congenital anomaly with MM was hydrocephalus.