Approximately 3 to 4 weeks after fertilization, the neural plate folds, creating the neural tube. There are multiple factors, environmental as well a genetic, that go in to ensuring a full closure. When this process is not fully completed, neural tube defects (NTD) result. Folic acid supplementation decreases the risk for failed closure. ACOG recommends that folic acid, 400 micrograms, should be offered to all women “capable of becoming pregnant” starting at least 1 month before pregnancy (see ‘Related ObG Topics’ for more on folic acid recommendations).
Spina Bifida – Failure of Spinal/Caudal Closure
Complex – Severe
75% of infants with myelomeningocele survive to early adulthood with modern therapies
Note: Approximately 30% of individuals with NTD will have severe, life-threatening latex allergy
ACOG recommends that “utero repair is an option for women who meet appropriate criteria… only in an established fetal therapy center”
Maternal and neonatal risks
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.