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Overview of postnatal outcome in children born with MMC in the Nordic countries
Nordic Network of Fetal Medicine
Gothenburg 16th April 2015
Ingrid Olsson Neuropaediatrician
Queen Silvia Children’s Hospital Gothenburg, Sweden
NaHonal network of neurpaediatricians in Sweden, responsible for the regional care of children with MMC
• First meeHng in 2004 • Aim: to write naHonal guidelines for MMC • What happens to our children aMer adolescence? • What are the medical needs on the threshold of adulthood?
NaHonal network of neurpaediatricians in Sweden, responsible for the regional care of children with MMC
• Inventories of the MMC populaHon – Born during the period 1986-‐1989 (1st July 2004)* n=175 – Born during the period 1990-‐1993 (1st July 2008) n=174 – Born during the period 1994-‐1997 (1st July 2012) n=134
Made possible thanks to the collaboraHon of colleagues and urotherapists at the regional centres in Umeå, Uppsala, Stockholm, Linköping, Lund and Gothenburg
*Olsson, Dahl, Ma`sson, Wendelius, Åström, Westbom. Acta Paediatr 2007
The prevalence of MMC / 10 000 1986-‐1989, 1990-‐1993, 1994-‐1997
3,75 3,38
3,07
0
2
4
Cohort 1 Cohort 2 Cohort 3
M Tsoulaki
Cohort all 1 2 3 Hydrocephalus 76% 86% 74% 67% Op tethered cord 33% 31% 35% 29% Op Chiari II 6% 6% 9% 2% Op scoliosis 22% 24% 23% 19% Scoliosis 35% 40% 32% 30% Epilepsy 10% 14% 7% 9% Pressure sores 18% 19% 20% 16% CIC 85% 85% 86% 85% ↓renal funcHon 3.0% 1.7% 3.5% 3.7%
CIC; Clean intermi`ent catheterisaHon M Tsoulaki
Cohort 1 2 3 all Independent walking indoors 27% 41% 38% 35% Walking aids indoors 20% 13% 18% 17% No walking 53% 45% 39% 46%
Motor impairment
M Tsoulaki
0 10 20 30 40 50 60 70 80 90
Medical problems in 483 adolescents with MMC born 1986-‐1997
0 10 20 30 40 50 60 70 80 90
100
Cohort 1
Cohort 2
Cohort 3
Comparison between the cohorts 1986-‐1989, 1990-‐1993, 1994-‐1997
Conclusion
Adolescents with MMC have several medical problems that may lead to serious life threatening complicaHons.
MulHdisciplinary, coordinated, life long follow up by specialists with knowledge of MMC is necessary.
Specialist care is gejng even more important as the prevalence of MMC is decreasing.
M Tsoulaki