Abstract

yelomeningocele, themost severe form of spina bifida, is a defect of primary neurulation that results from the M failed fusion in the caudal region of the neural tube, the so-called neuropore, at 25e28 days of gestation (12). The resulting unclosed segment of the neural plate (the neural placode) floats on top of a cerebrospinal fluidefilled, membrane-bound sac (9). Established risk factors, such as previous affected pregnancies, inadequate maternal intake of folic acid, pregestational diabetes, use of some antiepileptic drugs, and somegenetic pathways, such as folateehomocysteine pathway genes, have been linked to primary neurulation failure. Other suspected maternal risk factors are vitamin B12 status, obesity, hyperthermia, and diarrhea (10).

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