Pamela K. Burrows

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: Myelomeningocele is one of the most common birth defects, characterized by a defect in the bony spine and resultant extrusion of the spinal cord into a sac filled with cerebrospinal fluid.

TL;DR: Prenatal repair by hysterotomy may offer better neurological function than repair delayed until after delivery, but it can also increase maternal risk, including preterm labor and uterine dehiscence, and has an increased risk of fetal or neonatal death and preterm birth.

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: The data for the full cohort of 183 patients corroborate the original findings of Management of Myelomeningocele Study, confirming that prenatal repair improves the primary outcome composite score of mental development and motor function.