Clinical characteristics of neonatal meningomyelocele cases and effect of operation time on mortality and morbidity.

OBJECTIVE: We aimed to evaluate the clinical features, short-term prognosis, and effect of operation time on mortality and morbidity in neonates with meningomyelocele.

METHODS: This prospective study was conducted between January 2006 and December 2008. Clinical features, defective area, existence of additional anomalies, operation time, and morbidity and mortality data were recorded. The effect of operation time on mortality and morbidity was evaluated.

RESULTS: Patients (n = 28) were assessed during the study period. Mean birth weight, height, and head circumference were found to be 3,160 ± 582 g, 46.2 ± 3.3 cm, and 36.7 ± 4.1 cm, respectively. None of the mothers received folate supplementation. Hydrocephaly (n = 13), pes equinovarus (n = 4), pelvicalyceal ectasia (n = 4), acetabular dysplasia (n = 2), Chiari II malformation (n = 2), and hydronephrosis (n = 2) accounted for additional anomalies. The mean postnatal age for surgical operation was 3.2 ± 2.8 days; mean length of hospital stay was 10.2 ± 9.7 days. The cases operated after 72 h were hospitalized longer, received antibiotherapies for a longer duration and had higher total complication rates (p = 0.04, 0.02, and 0.01, respectively).

CONCLUSION: Surgical operation of patients with meningomyelocele within 72 h after delivery significantly reduces not only the duration of hospitalization and antibiotic usage, but also complication rates.