Specialists at the Fetal Care Center are among a select few experts in the Midwest—and the only center in the St. Louis region—who perform fetal surgery to treat myelomeningocele, a severe form of spina bifida. Our high-risk pregnancy doctors close the spinal opening while your unborn baby is still in the womb. Only select fetal centers have the comprehensive team of fetal and neurosurgeons with the skillsets to perform this complex surgery.
Unborn babies with a severe form of spina bifida known as myelomeningocele develop a sac containing the spinal cord and nerves on the outside of their back. These children have a higher risk of paralysis, motor problems, bladder and bowel problems, and hydrocephalus, or excess fluid in the brain. Learn more about spina bifida.
Fetal Surgery for Spina Bifida: What to Expect
Specialists at the Fetal Care Center perform open fetal surgery on unborn babies with myelomeningocele who meet certain criteria. Doctors place the sac of spinal cord and nerves back into the spinal canal while your unborn baby remains in the womb.
Research from the National Institutes of Health suggests that closing the spinal opening before birth improves the chances that a child will walk independently. Fetal surgery also reduces the need to divert, or shunt, fluid away from the brain.
Fetal surgery for spina bifida is typically performed between 24 weeks and 25 weeks, 6 days of pregnancy. During this procedure the surgical team:
- Gives you general anesthesia
- Makes an incision in your abdomen and uterus, much like a cesarean section
- Treats your unborn baby’s spinal defect by placing the exposed sac of spinal cord and nerves back into the spinal canal
- Closes surrounding tissue and skin over the opening to protect the spinal cord from exposure to amniotic fluid
- Closes the incision in your uterus and abdomen
After Fetal Surgery for Spina Bifida
Open fetal surgery increases the risk of complications, including early labor and delivery. After surgery, you:
- Stay at the Women & Infants Center until your doctor gives the okay to go home
- Remain on bed rest to lower the risk of early delivery
- Undergo weekly ultrasound screenings to monitor the health of your unborn baby
We recommend that you deliver at a hospital equipped to care for a high-risk pregnancy, such as the Women & Infants Center. After delivery, your baby may receive advanced medical care in our Level IV Newborn Intensive Care Unit (NICU). Our focus is on keeping mom and baby together, which is why our NICU is connected to labor and delivery.
Children with spina bifida may have developmental and physical problems. Your child receives exceptional care throughout childhood from the pediatric specialists at the Spina Bifida Clinic at St. Louis Children’s Hospital.
To make an appointment with a Washington University fetal care specialist at the Women & Infants Center, call 888.230.8832.