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Myelomeningocele (meningomyelocele or spina bifida) is a form of neural tube defect. In this condition, the spinal cord (myelon), its covering (meninges), and vertebral arches develop abnormally early in gestation (Fig. 1). Children born with this condition, which is one of the most complex birth defects compatible with life, have impairments of both the spinal cord and brain. Despite fortification of food with folic acid and the increased use of maternal folic acid, myelomeningocele has not been eliminated. Thus, the primary care pediatrician is likely to provide care for children who have this condition. The pediatrician should work with the child, family, and other clinicians in the community to establish sound chronic disease management procedures for these children, ensuring the provision of continuous and coordinated care of the highest quality.

The prevalence of myelomeningocele varies among countries; in the...

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