Neural tube defects (NTDs) are malformations of the central nervous system that represent the second most common cause of congenital morbidity and mortality, following cardiovascular abnormalities. Maternal nutrition, particularly folic acid, a B vitamin, is crucial in the etiology of NTDs. FA plays a key role in DNA methylation, synthesis, and repair, acting as a cofactor in one-carbon transfer reactions essential for neural tube development. Randomized trials have shown that FA supplementation during preconceptional and periconceptional periods reduces the incidence of NTDs by nearly 80%. Consequently, it is recommended that all women of reproductive age take 400 µg of FA daily. Many countries have introduced FA fortification of staple foods to prevent NTDs, addressing the high rate of unplanned pregnancies. These policies have increased FA intake and decreased NTD incidence. Although the precise mechanisms by which FA protects against NTDs remain unclear, compelling evidence supports its efficacy in preventing most NTDs, leading to national recommendations for FA supplementation in women. This review focuses on preconceptional and periconceptional FA supplementation in the female population of the Visegrad Group countries (Slovakia, Czech Republic, Poland, and Hungary). Our findings emphasize the need for a comprehensive approach to NTDs, including FA supplementation programs, tailored counseling, and effective national-level policies.

Syncytiotrophoblast (STB) vacuolization is common in term placentas, yet identical-appearing vacuoles are interpreted as physiological or degenerative depending on context, and, to our knowledge, a systematic description of their regional distribution within the STB in a defined cohort of uncomplicated term placentas is lacking. This pilot study aimed to define the regional organization of STB vacuolization in terminal villi within a single, consistently defined sampling site in uncomplicated term pregnancies. Using standardized transmission electron microscopy (TEM) protocols and blinded, independent scoring, we qualitatively evaluated vacuolar profiles in the subapical, perinuclear, and basal STB regions of placentas from ten uncomplicated singleton term pregnancies. Vacuolization followed a consistent, recurrent regional pattern across the cohort—small electron-lucent vesicles beneath the microvillous border, heterogeneous membrane-delimited compartments perinuclearly, and occasional larger vacuoles basally. These membrane-delimited profiles (membrane delimitation being an inclusion criterion) were observed in fields with preserved mitochondria and maintained microvillous architecture, suggesting that the regional context within the syncytial cytoplasm, rather than the mere presence of vacuoles, represents a candidate morphological criterion for distinguishing physiological vesicular activity from nonspecific degeneration, requiring direct validation against pathological comparator tissue. This pilot study is descriptive and requires validation in larger cohorts, pathological comparator groups, and complementary molecular approaches before its conclusions can be generalized; the proposed preliminary descriptive framework may offer a starting point for future studies interpreting trophoblast alterations in placental pathology and for contextualizing emerging environmental exposures, such as microplastic particles, at the maternal–fetal interface.