Arash Azizinezhad,1Negin Eizad,2Parsa taheri monazzah,3Mahdie Soleimany,4Farhad Karimijavan,5Fereshteh Gholami,6,*
1. Universal Scientific Education and Research Network (USERN) 2. Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran 3. Student of Guilan University of Medical Sciences, Iran 4. Jahrom University of Medical Sciences, Fars , Iran 5. Student of Islamic Azad University Tehran Medical sciences 6. Student Research committee, Bushehr University of Medical Science
Introduction: The term "spina bifida" (SB) means diseases caused by failure of the caudal neural tube in the fusion in the developing fetus, which is divided into three categories: open, occult (closed), and dysraphism. Lesions are usually in the lumbar and sacral regions, and higher lesions cause more severe disability and worse cognitive function. Myelomeningocele is the most severe and common form of SB. Myelomeningocele can lead to lifelong problems with mobility, sensation, urination, and bowel movements. The level of spinal deformity has a large impact on long-term survival rates. Advances in surgical techniques to repair defects associated with SB mean that more patients are now surviving to reproductive age and that there are no reports of decreased fertility. An increasing number are potentially pregnant.
Methods: The next systematic review of the studies conducted until 2022 was conducted using Scopus, PubMed, and Google Scholar databases, and among the collected articles corresponding to keywords, 21 articles were reviewed.
Results: Despite more women with SB seeking motherhood and more research on pregnancy in women with disabilities more broadly, little is known about the experiences of women with SB specifically in considering, planning, or experiencing pregnancy. However, the current literature on pregnancy in spina bifida is limited mainly to small case series that are specific to their obstetric outcomes. Even health care providers specializing in SB feel that they lack a basic understanding of the subject. Preconception counseling of women with SB is strongly recommended for those at or near childbearing age. Whether the risk of SB is related to the interaction between these genes, the presence of genes on the maternal or fetal genome, or the interaction of these genes with environmental factors is unclear. Daily intake of folic acid before pregnancy and during the first trimester of pregnancy significantly reduces the risk of fetal NTDs. During pregnancy, epilepsy management should optimize seizure control with the lowest and lowest dose of antiepileptic drugs (AEDs) and at the start of 5 mg of folic acid supplementation. Diabetes mellitus is already an independent risk factor for the development of fetal malformations in the central nervous system. Urological abnormalities in patients with SB can be complex and are best managed by a urologist.
Conclusion: The results of this study show that women with SB do not have a good understanding of their potential and risks during pregnancy. Additionally, women's negative experiences with health care providers when discussing pregnancy goals and being pregnant highlight the urgent need to educate health care providers about fertility, pregnancy, and birth outcomes specific to women with spina bifida. The persistent stigma and discrimination that many women with disabilities face in discussing and pursuing their fertility goals must be addressed and its adverse impact on the quality of health care reduced. Women with SB who wish to become mothers through childbirth deserve what all women deserve.
Keywords: Spina Bifida, Women, Reproductive Health