Before undergoing fetal surgery for myelomeningocele (MMC), the mother will receive deep general anesthesia, which also anesthetizes the fetus.

Fetal surgeons make an incision across the mother’s abdomen.

The maternal-fetal medicine specialist uses ultrasound to determine the location of the fetus.

The uterus is then opened with a specially designed device that controls bleeding, and the fetus is positioned so the defect is visible. Usually, the exposed spinal cord and nerves are contained in a sac. The sac is a thin membrane filled with fluid.

The pediatric neurosurgeon removes the sac on the baby’s back that covers the opening in the spinal cord.

The neurosurgeon and the fetal surgeon then close the defect in multiple layers, using a lacing technique.

First, the muscle layers are closed over the defect.

Then, the skin is closed over the muscle layers. This technique ensures a watertight closure.

The mother’s uterus is closed in multiple layers.

The abdomen is then closed and the mother is stabilized and returned to her room. The pregnancy then continues until planned delivery at 37 weeks gestation, most often in our Garbose Family Special Delivery Unit, created specifically for healthy mothers carrying babies with birth defects.