Predictors of morbidity and health related quality of life in children with spina bifida aperta

Jujju Jacob Kurian, (2014) Predictors of morbidity and health related quality of life in children with spina bifida aperta. Masters thesis, Christian Medical College, Vellore.


Download (23MB) | Preview

Download (31kB) | Preview


INTRODUCTION: Spina bifida is a congenital neural tube defect that results in incomplete closure of the spinal column. Children with spina bifida aperta which includes meningocoele, meningomyelocoele and lipomeningocoele suffer from various systemic problems. The most commonly involved systems are the genitourinary system, the gastrointestinal system, the musculoskeletal system and the central nervous system. Advances in neurosurgical, orthopaedic and urological management of these children have resulted in a better life expectancy and a better quality of life especially in the developed world. Key elements in the management of these children include early closure of the defect with institution of appropriate medical, surgical and supportive measures and lifelong follow up. Studies on the health related quality of life in children with spina bifida aperta especially from our country have been very few. Knowledge of their quality of life with respect to the general population, the various morbidity factors affecting them and the time of development of one of the most important cause of mortality namely renal impairment may go a long way in helping the clinicians and the care givers improve their quality of life. AIM/ OBJECTIVES: To assess in childen with spina bifida aperta, the quality of life, renal impairment, various morbidity factors and those on various management modalities for neurogenic bowel and bladder. MATERIALS AND METHODS: 68 children with spina bifida aperta were assessed. A history which included general data, bowel or bladder related accidents and the number of garments changes per day was taken. A clinical examination enumerating the lesion, presence of co morbidities, anthropometry and neurological examination were performed. A urine microscopy, serum creatinine and ultrasound of the abdomen were done and if abnormal were followed by a MCU and CMG. DMSA was done in case of VUR. All children who were 5 years or more were administered questionnaires to assess the quality of life. The data was entered in Microsoft excel and analyzed using SPSS 16. RESULTS AND CONCLUSION: 31% of children were found to have poor quality of life. 38.24% of children had evidence of renal changes as evidenced by dilated upper tracts and/ or scarring at the time of evaluation. Urinary incontinence was seen in 68.9% and faecal incontinence in 61.29%. 38.09% of children were not ambulant and hydrocephalus was seen in 11.76%. 58.82% of children were on CIC whereas 35.48% were on bowel washes. None of the children had mental retardation.

Item Type: Thesis (Masters)
Additional Information: Reg.No.18113302
Uncontrolled Keywords: Predictors, morbidity, health, quality of life, children, spina bifida aperta.
Subjects: MEDICAL > Paediatric Surgery
Depositing User: Subramani R
Date Deposited: 16 Feb 2020 02:46
Last Modified: 16 Feb 2020 02:46

Actions (login required)

View Item View Item