Fetal surgery for myelomeningocele

Myelomeningocele is a devastating birth defect affecting a significant numb er of live births worldwide. Prenatal repair of myelomeningocele has been p erformed in the United States for 5 years with mixed results. The initial i ntent was to preserve distal neurological function by covering the exposed spinal cord. Although there has been relatively little effect on distal sen sorimotor function, prenatal repair serendipitously led to an apparent redu ction in hindbrain herniation and a possible decreased need for ventriculop eritoneal shunting. The long-term clinical consequences of these findings a re not clear. What is clear, however, is that further study in the form of a prospective, randomized trial is mandatory. Curr Opin Obstet Gynecol 13:2 15-222 (C) 2001 Lippincott Williams & Wilkins.