PRENATAL-DIAGNOSIS AND OUTCOME OF PATIENTS WITH SPINA-BIFIDA

The frequency of new cases of myelomeningocele has largely decreased i n the last 10 years in several countries of western Europe; the emerge nce of widespread prenatal diagnosis is probably one of the main reaso ns, However, the outcome of spina bifida which eludes the prenatal dia gnosis, or in cases where termination was refused by parents, remains badly known. To our knowledge, there is no recent data on the outcome of children with spina bifida. Moreover, available data, depending on their European or American origin, indicate different functional outco mes. This led us to re-evaluate the mechanisms involved in the prenata l diagnosis of spina bifida and the outcome of our patients,vith spina bifida. The aim of this paper is to give a short description of the ' 'rules and principles'' of prenatal prenatal diagnosis as it is applie d in our centres, as well as a brief overview of the outcome of 137 ca ses of spina bifida. In the retrospective study, three major aspects w ere evaluated: 1) frequency and types of surgeries and their benefits; 2) socio-psychological adaptation of the the patients; 3) educational level and learning disabilities (C) 1998 Elsevier, Paris.