Myelomeningocele (spina bifida) is the most common neural tube defect. It is characterized by a cleft in the vertebral column, with a corresponding defect in the skin.

We report a clinical observation of a female newborn baby admitted for management of a respiratory distress and congenital abnormality of the lumbar area; No Ultrasound was done before the delivery.

The clinical examination of the newborn has shown macrocephaly (HC: 41cm), a defective lesion in the lumbar region (Figure 1), flaccid paralysis of the lower extremities, sensivity deficit and absence of reflexes. Other systemic examinations were normal.

Cranial ultrasound has shown a hydrocephalus with dilated ventricles (Figure 2), The MRI confirmed the previous findings of hydrocephalus with Arnold-Chiari malformation and lumbar myelomeningocele. The patient was addressed to Neurosurgical Intensive Care Unit for a surgical management.

The assessment of risk factors in the mother showed absence of folic acid supplementation, with daily ingestion of fenugreek during the pregnancy. Fenugreek is an herbal medicine, often used in the Mediterranean area to stimulate appetite in pregnant women and facilitate childbirth and the milky rise. Unfortunately, it is also associated with a high risk of occurrence of neural tube defects [1].

The strategy of the prevention of neural tube defects should be established especially in pregnancies of a high risk of recurrence of neural tube abnormalities by the eviction of fenugreek consumption and folic acid supplementation during pregnancy.

Keywords: Myelomeningocele; Spina bifida; Fenugreek