Abstract
Objective: Neural tube defects (NTDs) are common in northern areas of Khyber Pakhtunkhwa (KPK) and need a lot of community education for the parents regarding this disease, which impaired the patients for their whole life. The study aimed to assess the contribution of a family history of myelomeningocele and the resulting incidence of Chiari II malformation.
 Materials and Methods: A total of 131 patients were observed to determine the frequency of the Chiari II malformation in patients with myelomeningocele who presented in Ayub Teaching Hospital, Abbottabad. All neonates were sent to the radiology department for MRI. A repair procedure for meningomyelocele was done.
 Results: The mean age was 16.56 days. In 53.4% of neonates, there was a familial history of spinal dysraphism, while in 46.6% there was no familial history. Chiari II malformation was present in 23.7% of patients who presented with myelomeningocele. A significant difference (p-value < 0.00001) existed between the presence/absence of a family history of myelomeningocele and Chiari II malformation out of the total.
 Conclusion: Early surgery, along with a multidisciplinary approach, provides the best opportunity for improved results and survival.
 Keywords: Meningomyelocele, Neural Tissue, Maternal Folate Intake, Meningomyelocele (MMC) Repair.
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