Objective: To determine the risk factors, presentation and outcome of meningomyelocele repair Methods: We reviewed 150 cases operated for meningomyelocele (MMC) at Jinnah Postgraduate Medical Centre Karachi between May 2015 and May 2018. Data of infants operated for MMC repair was extracted including socioeconomic status, maternal folate intake during pregnancy, head circumference, location and width of the defect, accompanying bladder and limb anomalies and treatments administered. Patients were followed up for a mean period of six months. Results: A total of 150 children were evaluated, out of which there were 83(55.3%) males and 67(44.7%) females. All belonged to low socio economic group and prenatal maternal folate intake as risk factor was positive in 103(68.7%) cases. Mean head circumference was 37.4 cm (range, 30.7 to 50 cm). Based on their location, 83(55%) of the defects were lumbosacral, 38(25.4%) were lumbar, 16(10.7%) were thoraco lumbar, 10(6.7%) were thoracic and three (2%) were cervical. Mean size of the meningomyelocele sac was 4.3 cm×5.6 cm (range, 1cm×2cm to 11cm×8.4cm) and 21(14%) of the babies had a skin defect requiring flap. According to accompanying anomalies, 98(65.3%) of the babies had hydrocephalus, 13(9%) had club foot, four (2.7%) had diastematomyelia and three (2%) had tethered cord. Eighty seven (58%) patients had neurological deficit pre operatively and eight (5.4%) patients with normal power deteriorated after surgery out of which five (3.3%) developed paraplegia and three (2%) developed paraparesis. CSF leak was the major complication encountered in 16(11%) followed by meningitis in seven (5%), while the overall mortality was four (2.6%). Conclusion: The practice of periconceptional folic acid supplementation is essential to reduce the prevalence of neural tube defects (NTDs) in the developing world. Improved maternal nutrition with access to quality antenatal care is vital to decrease the prevalence and health burden. doi: https://doi.org/10.12669/pjms.36.3.1237 How to cite this:Rehman L, Shiekh M, Afzal A, Rizvi R. Risk factors, presentation and outcome of?meningomyelocele repair. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.1237 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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机译：目的：确定植物蒙茂塞修复方法的危险因素，展示和结果：2015年5月至2018年5月，我们审查了在Jinnah Postgraduate Centr Karachi的Jinnah Postgradued Center Karachi运营的150例。状态，孕妇叶酸在妊娠期间摄入，头围，缺陷的位置和宽度，伴随膀胱和肢体异常和治疗施用。患者随访六个月的平均时间。结果：评价150名儿童，其中有83例（55.3％）男性和67名（44.7％）的女性。所有属于低社会经济群和产前产妇叶酸摄入量，因为危险因素在103（68.7％）患者中是阳性的。平均头周长为37.4厘米（范围，30.7至50厘米）。基于它们的位置，83（55％）的缺陷是腰骶部，38例（25.4％）是腰椎，16（10.7％）是胸腰，10（6.7％）是胸部，三（2％）是颈椎宫颈。植物细胞囊囊的平均尺寸为4.3cm×5.6厘米（范围，1cm×2cm至11cm×8.4cm）和21（14％）的婴儿具有皮肤缺陷需要襟翼。根据伴随的异常，98名（65.3％）的婴儿患有脑积水，13例（9％）患有俱乐部脚，四个（2.7％）有DiaSematomyelia，三（2％）有束缚绳。八十七（58％）患者具有神经功能缺陷的术前术，八（5.4％）患者患者在手术后劣化，其中五（3.3％）开发的截瘫和三（2％）发育的剖腹产。 CSF泄漏是16（11％）遇到的主要复杂性，其次是脑膜炎（5％），而总体死亡率为4（2.6％）。结论：仔细叶酸补充的实践对于减少发展中国家神经管缺陷（NTDS）的患病率至关重要。提高母体营养，可获得优质产蛋护理至关重要，以降低患病率和健康负担。 DOI：https://doi.org/10.12669/pjms.36.3.1237如何引用这一点：rehman l，shiekh m，afzal a，Rizvi r.危险因素，展示和结果？脑膜蒙内塞克修复。 Pak J Med Sci。 2020; 36（3）：---------。 DOI：https://doi.org/10.12669/pjms.36.3.1237这是在Creative Commons归因许可（http://creativommommons.org/licenses/by/3.0）下分发的开放式访问文章，哪些只要正确引用原始工作，允许在任何媒体中不受限制使用，分发和再现。
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