Fetal myelomeningocele repair: a new standard of care.

Myelomeningocele, also known as spina bifida, is one of the most common congenital anomalies of the central nervous system and the most common open, prenatally repaired birth defect. The Management of Myelomeningocele Study (MOMS), which compared the results of prenatal and postnatal myelomeningocele repair, found prenatal surgery to be much more effective than postnatal surgery. During surgery, the surgeon makes a hysterotomy and repairs the fetal myelomeningocele without removing the fetus from the uterus. After the repair is completed, the surgeon closes the uterus. The obstetric team monitors the mother closely with a goal of performing a cesarean delivery at 37 weeks' gestation. The fetal surgery nursing team used innovative simulation teaching methods to establish and maintain fetal surgery team member competence, resulting in a successful program with good outcomes.