Fetal Surgery for Myelomeningocele?

The possibility of surgical repair of fetal anomalies in utero has long tantalized obstetricians and pediatric surgeons, especially since the development of high-resolution real-time ultrasonography. The presumption has been that earlier in utero repair would provide superior outcomes for the offspring than would postnatal surgery. However, postnatal treatment is much simpler and is not traumatic to the mother. Successful fetal surgery for any condition thus requires an accurate identification of which fetuses are at highest risk for a poor outcome if repair is delayed until after birth. Despite the promise of fetal surgical procedures, such repair of structural malformations has . . .