ABSTRACT

Myelomeningocele is the most severe of the spinal dysraphic states and still the most common, although its incidence is decreasing with improved prenatal maternal nutrition and through the availability of prenatal screening mechanisms. Myelomeningocele is a central nervous system fusion defect. Neural tube defects affect both men and woman and have a slight female preponderance. There have been clusters of increased incidence of myelomeningocele in certain populations, such as the Irish, British, Sikhs, Guatemalans, and the Egyptians of Alexandria. Siblings of an affected child have an increased risk of neural tube defects when compared with the general population. The rate of recurrence ranges from about 1 percent to nearly 10 percent in different series. A clear correlation between maternal diet and neural tube defects has been determined. A seven-fold reduction in neural tube defects has been achieved with folate and vitamin supplementation before and during pregnancy.