Myelomeningocele treatment options
While an MMC diagnosis may be life-changing, there are myelomeningocele treatment options available that may help your child thrive – both during pregnancy and after they've entered the world.
And at the Colorado Fetal Care Center, your treatment options are more than just that – they're carefully designed strategies to give your baby the best quality of life. We have a specialized team dedicated to treating babies with myelomeningocele. And as one of the nation's top fetal care centers, we offer some of the most innovative fetal therapies available.
Before determining if a patient qualifies for MMC fetal surgery, our fetal care team works closely with you and collaborates with other specialists. Before deciding on a course of action, we evaluate your baby's particular condition and the severity of their MMC using fetal diagnostic tests like ultrasound, MRI and echocardiography. Only then do we design and offer a treatment plan.
Prenatal myelomeningocele repair
For some families, our fetal experts offer to treat MMC before the baby is even born by performing a myelomeningocele repair in utero. We choose to perform this open fetal surgery if it can:
- Give an unborn baby their best chance at surviving and thriving
- Improve outcomes
- Prevent other injuries or complications from developing
- Prevent further neural damage and more cerebrospinal fluid from leaking
- Decreases the chances the baby will need a shunt in the future
When a fetus has an open neural tube defect like MMC, their nerves are exposed to elements that could cause further harm, like amniotic fluid, cerebrospinal fluid and direct trauma.
What to expect from open fetal surgery for MMC spina bifida repair
During the MMC fetal surgery, a maternal fetal medicine specialist will make an incision in the abdomen to open the uterus and expose the defect in your baby's spine. Then a highly specialized pediatric neurosurgeon will repair the myelomeningocele and close the skin of your baby's back over the opening to protect their still-developing neural tissue – all while you're still pregnant.
Before the procedure begins, your obstetric and fetal anesthesiologist will administer anesthesia to put you to sleep and relax the uterus; the anesthesia passes through the placenta to your unborn child, allowing the surgical team to open the uterus, perform the in-utero MMC repair and close the uterus – all without interfering with your pregnancy.
Once the procedure is finished, we leave the baby to keep growing and developing, all while monitoring closely with frequent ultrasounds. We’ll then deliver your baby via cesarean section around 37 weeks' gestation.
What are the risks of open fetal surgery?
Risks to the mother from open fetal surgery may include obstetrical complications and potential scarring that could affect future pregnancies.
There is some risk to the fetus during in-utero surgery, but the team at the Colorado Fetal Care Center has successfully performed more than 90 prenatal spina bifida repairs. In our dedicated fetal surgery suite, our team of specialists is ready and capable of handling anything that may occur during the treatment or birth process.
Post-birth myelomeningocele treatment
If your fetal care team decides the best course of action is to repair your baby’s MMC after they're born, the treatment includes:
- Frequent ultrasounds during pregnancy to monitor fetal growth
- Delivering the baby via cesarean section (C-section) at full term
- An evaluation by your baby's care team and neurosurgeon after delivery
- Surgery to close the spina bifida within the first two days of life
Your child's care team will also evaluate them for signs of increased pressure in their brain (a condition known as hydrocephalus). If present, they'll likely insert a ventriculoperitoneal shunt, which is a tube that helps to drain excess spinal fluid from the brain into the abdominal cavity.
Care typically doesn't stop once your child is born. They'll receive follow-up care and be monitored by a multidisciplinary team of neurology, orthopedic, occupational therapy, pediatric, physical therapy and urology specialists, and others as needed.
Why choose the Colorado Fetal Care Center to treat your baby's myelomeningocele?
Our team at the Colorado Fetal Care Center has the experience and expertise to meet any of your and your baby's needs. From pregnancy management and diagnosis, to treatment and long-term pediatric subspecialty care, we have the capabilities, team and facilities to provide the highest quality care and best possible outcome.
Our average delivery age for babies who've undergone in-utero MMC repair is 34 weeks, meaning we give your baby as much time as possible to grow.
When you come to the Colorado Fetal Care Center for the diagnosis and treatment of your baby's myelomeningocele, you're cared for by a dedicated team of experts who have spent years researching, innovating and performing this treatment.
Comprehensive, consistent care
We make it easier on mom, baby and the whole family by surrounding you with the same faces every day. You'll meet with every provider on your care team on day one. And this same team will be with you every step of the way, so they know all the details of your care. And we know that your baby's needs don't end at delivery, which is why we make the transition to the Neonatal Intensive Care Unit (NICU), specialty care and home as seamless as possible.
No question goes unanswered
All of these specialists and providers are under the same roof at Children's Colorado. This means that your questions are answered faster, you have instant access to our expertise, and we're ready to handle anything that may arise.
We keep families together
We know how nervous and excited you are to meet your new baby, which is why we keep your family close together. In fact, Children's Colorado is one of the few children's hospitals in the nation with a labor and delivery unit.
Our Maternal Fetal Care Unit (MFCU) and Level IV NICU are right down the hall from each other, so you're able to easily visit your newborn as much as possible, and this is all under the same roof as nationally-ranked pediatric care.
If you are interested in learning more about our fetal care specialists, please contact the Colorado Fetal Care Center at 1-720-777-4463.