title: Open fetal surgery for myelomeningocele.
abstract: In a recently completed randomized, prospective clinical trial, fetal repair for myelomeningocele was shown to result in reduced rates of hydrocephalus requiring placement of a ventriculoperitoneal shunt, improvement in Chiari malformation Type II, and improvement in neurological function compared with standard postnatal repair. Successful fetal surgery requires the active participation and interaction of several clinical teams. Each group has a specific role, and overlap is often required at different points of the treatment plan. Extensive multispecialty discussions with the patient and family are necessary before informed consent can be obtained. Fetal surgery carries significant risks to the mother and fetus and these must be carefully considered prior to a final treatment decision. This review will summarize the evaluation and treatment of patients undergoing fetal repair for myelomeningocele at one institution.
authors.affiliation: Departments of Neurological Surgery, University of California, San Francisco, CA 94143-0112, USA. guptan@neurosurg.ucsf.edu
authors.forename: Nalin
authors.initials: N
authors.lastname: Gupta
authors.forename: Jody A
authors.initials: JA
authors.lastname: Farrell
authors.forename: Larry
authors.initials: L
authors.lastname: Rand
authors.forename: Charles B
authors.initials: CB
authors.lastname: Cauldwell
authors.forename: Diana
authors.initials: D
authors.lastname: Farmer
mesh_terms: D005260:Female; D046128:Fetal Therapies; D005333:Fetus / Q000601:surgery*; D006801:Humans; D020883:Hysterotomy; D008591:Meningomyelocele / Q000196:embryology / Q000473:pathology / Q000601:surgery*; D011247:Pregnancy