🧬 Chapter 754 · Meningomyelocele (Spina Bifida)

Nelson Textbook of Pediatrics 22nd Edition | Meningomyelocele: neural tube defect, Chiari II malformation, hydrocephalus (77-95%), neurogenic bladder/bowel, latex allergy, orthopedic complications (scoliosis, hip dislocation, clubfoot). Prenatal folic acid prevention, fetal surgery, transition to adult care.

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📋 30 Clinical Scenarios — Meningomyelocele (Spina Bifida)

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Spina Bifida

Select a spina bifida presentation to review diagnostic and management approach (Nelson Ch 754).

📋 Stepwise Management of Meningomyelocele

🔑 Key Principles — Chapter 754
• Prenatal: Maternal serum AFP, high-res ultrasound (lemon/banana signs). Folic acid (0.4 mg daily) prevents 70% of NTDs. Prenatal surgical closure reduces shunt dependence.
• Postnatal closure: Within 24-48 hours. Monitor for hydrocephalus (77-95% require VP shunt). Chiari II malformation (symptomatic in 20%: stridor, apnea, dysphagia).
• Neurogenic bladder: Clean intermittent catheterization (CIC) from birth, anticholinergics. Avoid asymptomatic bacteriuria treatment.
• Latex allergy: Very common; avoid latex products, caution with banana/avocado/kiwi.

    ⚡ Reflex Prompts — Spina Bifida Clinical Decisions

    📖 Summary: Meningomyelocele (Spina Bifida) (Nelson 754)