Spina bifida

Myelomeningocele is a severe form of spina bifida, the most common birth defect of the central nervous system. If you are a parent who has learned that your unborn baby has spina bifida, you probably feel scared, angry and sad. We all have dreams for our children and we want the best for them. Learning that your child is at risk for death or disability is hard for the whole family.

The Fetal Concerns Center of Wisconsin helps families like yours every day. The Fetal Concerns Center offers the latest diagnostic tools and treatment options for spina bifida. From diagnosis to birth, the Fetal Concerns Center uses a team approach to teach and support families.

Spina bifida

Spina bifida is a defect in the closure of the neural tube (the skin and tissue that covers the spinal cord), also known as a neural tube defect. The neural tube is the tissue of a fetus (unborn baby) that becomes the brain, spinal cord and the bones around them, including the skull and spine. This neural tube usually is closed by the fourth week of pregnancy. In spina bifida, the neural tube does not close completely, leaving the delicate spine open to possible injury. This is called a myelomeningocele

Spina bifida ranges in severity. Some children have mild or no symptoms. Others have lifelong disability, including inability to control their bowel or bladder, paraplegia (little or no ability to move the legs) or quadriplegia (little or no ability to move the arms and legs). For a small percentage of children, it is fatal. Learn more about spina bifida and how it may affect your baby.

Treatment

For many years, spina bifida has been treated with surgery after the baby is born. During this surgery, tissue that grew outside the body is put inside and the hole in the back is closed. 

Recently, a study was conducted to test whether it was better to close this hole before or after the baby is born. The results from this study showed babies who had the surgery before birth were less likely to need a ventriculoperitoneal shunt (a tube that helps drain excessive fluid collections in the child’s brain). The study also showed that some of the motor (muscle) and ambulatory (walking) skills were better than those who received the standard surgery after birth. This study opens up a new treatment option for parents to consider.

The Fetal Concerns Center at Children’s Hospital now performs prenatal spina bifida surgery. However, prenatal surgery may not be an option in every case. Some of the conditions that must be met in order to have the prenatal surgery include:

  • The myelomeningocele must be located within a specific area of the back.
  • The mother must be at least 18 years old.
  • The surgery must be done within a certain time period in the pregnancy.
  • The baby must not have a genetic problem or any other major birth defect.
  • The baby must have a normal echocardiogram (an ultrasound picture of the heart).
  • The mother must be pregnant with only one baby.
  • The mother cannot be obese (have a body mass index higher than 35).
  • The mother must not have any one of a number of health conditions.
  • The mother must be willing to stay in the Milwaukee area for the rest of her pregnancy and deliver the baby at the Froedtert & The Medical College of Wisconsin Birth Center.

While prenatal surgery has potential benefits, it also has risks for both the mother and the baby. Doctors at the Fetal Concerns Center will help you decide whether prenatal surgery is the right option for you and your baby.