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Q&A: Spina Bifida Myelomeningocele

My baby girl was born with spina bifida myelomeningocele and my ob/gyn told me that the doctor who read my 20 week sonogram should have caught this and told me about it so that I could have had it repaired before my baby was born. Now that she’s born, her treatment options are much more limited. Did the ultrasound doctor commit medical malpractice?

A: Your ultrasound radiologist likely committed medical malpractice. Ultrasound today is quite effective in detecting spina bifida and assessing its severity. There are telltale signs that alert doctor to the possibility of spina bifida. When reading an ultrasound, radiologists should look for the “banana sign” and the “lemon sign” which are indicators of open neural tube defects. Click here to view some example pictures of spina bifida sonograms

If you received a blood test while pregnant, was your Alpha Fetoprotein level high? That is another sign that spina bifida should be investigated. There are several types of spina bifida. Spina bifida occulta is difficult to see on ultrasound. Meningocele and myelomeningocele are more pronounced and severe.

When these more severe types go undetected, the child can suffer further harm from vaginal birth. At the very least, c-sections should be performed on mothers carrying spina bifida fetuses. If the defect is caught in time, prenatal surgery can effectively treat the problem. The Fetal Care Center of Cincinnati is one center that provides this service. To learn more, read about the MOMS clinical trial or pick up these articles:

  • Adzick NS, Sutton LN, Crombleholme TM, et al: Successful fetal surgery for spina bifida. Lancet352:1675, 1998.
  • Adzick NS, Walsh DS: Myelomeningocele: Prenatal diagnosis, pathophysiology, and management. Semin Pediatr Surg. 12: 168-174, 2003.
  • Bruner JP, et al: Endoscopic coverage of fetal open myelomeningocele in utero. American Journal of Obstetrics and Gynecology 176:256, 1987.

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