John W. Brock

TL;DR: Prenatal surgery for myelomeningocele reduced the need for shunting and improved motor outcomes at 30 months but was associated with maternal and fetal risks and increased risk of preterm delivery and uterine dehiscence at delivery.

TL;DR: Larger ventricles at initial screening are associated with an increased need for shunting among those undergoing fetal surgery for myelomeningocele and care should be exercised in recommending prenatal surgery when the ventricle size is 15 mm or larger because prenatal surgery does not appear to improve outcome in this group.

TL;DR: This research presents a novel and scalable approach called “informed consent” that allows for real-time decision-making about whether or not to admit a child to hospital for treatment with a serious medical condition.

TL;DR: Long-term benefits of prenatal surgery included improved mobility and independent functioning and fewer surgeries for shunt placement and revision, with no strong evidence of improved cognitive functioning.

TL;DR: Neurogenic bowel and bladder management continues to be a significant issue for patients after fetal myelomeningocele closure and after fetal surgery patients should be followed closely, similar to patients who undergo postnatal closure.