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Neural Tube Defects


What are neural tube defects?

Neural tube defects are birth defects that affect the brain and spinal cord. During development of the fetus, the neural tube develops into the spinal cord, brain, and spinal column. This neural tube normally closes within the first month of pregnancy. A neural tube defect develops when the neural tube does not close completely.

What are the common types of neural tube defects?

Spina bifida and anencephaly are the most common neural tube defects. Spina bifida occurs when the vertebrae (bones) in the spine do not form correctly. The spine does not close completely around the spinal cord. The nerves in your child's spinal cord may be exposed, or form outside his vertebrae or skin. There are several types of spina bifida. Each type may affect your child in a different way. Anencephaly occurs when major parts of the brain, skull, and scalp are missing. A fetus with this condition usually does not survive for very long after birth.

What causes or increases the risk for neural tube defects?

The cause of neural tube defects is unknown. The following may increase your risk of having a baby with a neural tube defect:

  • You have a neural tube defect or you have previously been pregnant with a baby with a neural tube defect
  • Family history of a neural tube defect
  • Use of antiseizure medicines before and during pregnancy
  • Obesity or diabetes
  • Low intake of folic acid before pregnancy

How are neural tube defects diagnosed?

Screening tests, such as a blood test and an ultrasound, can be done during pregnancy. Tests may show an increased risk for a neural tube defect. Screening tests are usually done during the second trimester. If screening tests show an increased risk, you may need additional tests. Examples include a more detailed ultrasound of the baby's spine and skull and an amniocentesis. An amniocentesis is a procedure to take a sample of the amniotic fluid that surrounds your baby in the uterus. The fluid is sent to the lab for tests. Spina bifida may not be diagnosed until after birth. An ultrasound, CT scan, or MRI may be done to diagnose spina bifida after birth.

How are neural tube defects treated?

Treatment may not be needed for mild spina bifida. Surgery can be done to close or place the spinal cord back into the vertebrae. Surgery may be done during pregnancy or after birth. After surgery, long-term care will be needed to treat conditions or disabilities caused by spina bifida.

How can I help prevent neural tube defects?

  • Get the right amount of folic acid each day before you get pregnant. Neural tube defects develop during the first month of pregnancy, possibly before you know you are pregnant. If you are planning to get pregnant or are pregnant, get 400 to 800 micrograms (mcg) each day.
  • Most women do not get enough folic acid from foods alone. You will need to take a folic acid supplement to make sure you get enough each day. You should start taking supplements at least 1 month before you get pregnant. Continue to take them through the first 3 months of pregnancy or as directed.
  • You may need up to 4,000 mcg if you have increased risk of having a baby with a neural tube defect. Women with higher risk should start taking folic acid 3 months before you get pregnant. Continue to take them through the first 3 months of pregnancy or as directed.

Which foods are good sources of folic acid?

Your healthcare provider may recommend that you eat foods high in folic acid. The following foods are good sources of folic acid:

  • Flour and bread
  • Breakfast cereal
  • Pasta
  • Corn tortillas, tortilla chips, taco shells, and tamales
  • White rice
  • Beans
  • Leafy green vegetables
  • Orange juice

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