title: [How I do it: neural tube defects in nicaragua].
abstract: Nicaragua does not have a national plan for folic acid fortification. Mothers are often very young. At La Mascota we operated more than 40 cases per year. Delayed arrival is a problem. Pre operative infection has to be ruled out. Vancomycin and Ceftriaxone are indicated. Strict scrub rules are applied. Restore the shape of the cord by suturing the placode. Do not close muscle layer.
authors.affiliation: Neurosurgeon, Hospital Infantil Manuel de Jesus Rivera, "La Mascota", Managua, Republic of Nicaragua.
authors.forename: Juan Bosco
authors.initials: JB
authors.lastname: Gonzalez