Neural tube defects are are one of the more common congenital anomalies to occur. Such defects result from improper embryonic neural tube closure. The most minimal defect is called spina bifida, with failure of the vertebral body to completely form, but the defect is not open. Open neural tube defects with lack of a skin covering, can include a meningocele, in which meninges protrude through the defect. Here is a large meningomyelocele in which the defect is large enough to allow meninges and a portion of spinal cord to protrude through the defect. Such defects can be suggested by an elevated maternal serum alpha-fetoprotein (MSAFP).