TY - CHAP M1 - Book, Section TI - Myelomeningocele A1 - Bianchi, Diana W. A1 - Crombleholme, Timothy M. A1 - D'Alton, Mary E. A1 - Malone, Fergal D. PY - 2015 T2 - Fetology: Diagnosis and Management of the Fetal Patient, 2e AB - Key PointsOpen spinal cord defect that protrudes dorsally, is not covered by skin, and is associated with spinal-nerve paralysis.Current prevalence in the United States is still 0.5 to 1 case per 1000 pregnancies.Maternal risk factors include obesity, anticonvulsant medication, short interpregnancy interval, and genetic polymorphisms in various enzymes in the homocysteine methylation pathway.Sonographic findings include a small biparietal diameter, scalloping of the frontal bones, a compressed cerebellum, lateral ventriculomegaly, Chiari II abnormalities, splaying of dorsal vertebrae, and a dorsal sac.Karyotype should be performed, even in isolated neural tube defects.A prospective clinical trial comparing outcomes for open fetal surgery compared to standard postnatal surgery is in progress.Long-term outcome depends on the level of the spinal defect and the presence of associated anomalies.Morbidity has been significantly improved by interventricular shunting for hydrocephalus and clean intermittent bladder catheterization to reduce renal complications.Most neural tube defects are isolated and have a multifactorial inheritance pattern. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - obgyn.mhmedical.com/content.aspx?aid=1106396733 ER -