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Fetal Surgery: Myelomeningocele Repair

Open fetal surgery for spina bifida improves long-term neurological outcomes through intrauterine repair.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Fetal Surgery: Myelomeningocele Repair?

Fetal myelomeningocele repair is an advanced operation generally performed between 19-25 weeks of gestation, in which the open neural tube defect is closed surgically inside the uterus. The aim is to prevent damage from amniotic fluid to the spinal cord and the development of Chiari II malformation.

The MOMS (Management of Myelomeningocele Study) trial proved that intrauterine surgery reduces the need for postnatal ventriculoperitoneal shunting, improves motor function at 30 months, and increases the chance of Chiari II malformation reversal. Fetoscopic approaches are also being developed and reduce maternal morbidity.

Patient selection critically depends on BMI, preterm birth risk, placental location, and informed consent. Center standards mandate a multidisciplinary team (maternal-fetal medicine, pediatric neurosurgery, neonatology, anesthesia).

Symptoms

Open neural tube defect on antenatal ultrasound
Ventriculomegaly and Chiari II findings
Prenatal imaging of lower extremity motor dysfunction
Elevated maternal serum alpha-fetoprotein
Positive amniotic fluid acetylcholinesterase
Foot deformities (such as talipes equinovarus)

Risk Factors

Previous neural tube defect history
Folic acid deficiency
Pregestational diabetes
Use of valproate and carbamazepine
Maternal obesity
Family history of neural tube defect

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When a neural tube defect is detected on the anomaly scan
  • When ventriculomegaly or Chiari II malformation is observed
  • After referral to a fetal surgery center
  • When antenatal lower extremity motor abnormalities are observed

Treatment Methods

01
Multidisciplinary evaluation and confirmation of patient selection criteria
02
Open fetal surgery: hysterotomy and neural plate repair
03
Fetoscopic surgery (in selected centers)
04
Magnesium sulfate and tocolytic therapy
05
Cesarean delivery (planned at 37 weeks)
06
Postnatal neurosurgical and orthopedic follow-up

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.