Neural tube defects
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Normally, in human embryos, the closure of the neural tube occurs around the 30th day after fertilization. However, if something interferes and the tube fails to close properly, a neural tube defect will occur. Among the most common tube defects are anencephaly, encephalocele, and spina bifida. The incidence of neural tube defects is 2.6 in 1,000 worldwide.
Pregnant women taking medication for epilepsy have a higher chance of having a child with a neural tube defect. Research has shown that women with folic acid deficiences also have a higher chance of having a child with a neural tube defect, but this is only one factor. Taking folic acid does not completely negate the risk of neural tube problems, but it does significantly reduce the risk.
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A higher MSAFP level indicates a greater risk for anencephaly and open spina bifida. MSAFP screening is 80% and 90% sensitive for spina bifida and anencephaly, respectively.