Myelomeningocele (Spina Bifida)

Myelomeningocele (pronounced my-elo-men-IN-go-seal) (MMC) is a birth defect in which the backbone and spinal cord do not come together properly during development in the womb. This results in a visible, fluid-filled sac on a baby’s lower back and damage to the spinal cord as the pregnancy continues.

MMC is the most common type of spina bifida. It is a neurological condition that has been linked to a deficiency of folic acid. It can cause paralysis, water build-up in the brain (hydrocephalus), Arnold Chiari malformation type II and kidney problems.

With the right care though, most children with MMC go on to live long lives, especially when condition is diagnosed and treated early.

The SSM Health Cardinal Glennon St. Louis Fetal Care Institute has one of the most experienced teams in the country for helping children with spina bifida. Traditionally, spina bifida was treated with post-delivery surgery. As of 2011, our specialists also are now able to perform open fetal repair surgery.

Our team of pediatric specialists, neurosurgeons, and nurses are leaders in treating myelomeningocele, and work with patients locally and from across the country.

How is Myelomeningocele Diagnosed?

MMC is typically detected by a routine ultrasound between weeks 16 and 18 of a pregnancy. Indications of this condition include a cystic mass on a baby’s spine. Higher than normal levels of alpha-fetoprotein (AFP) in the blood and amniotic fluid can also confirm this diagnosis.

Further diagnostics are required to detect if your child has also developed hydrocephalus, the Chiari malformation, and any other problems with their lower extremities. In each case, we perform:

  • Fetal MRI to gain more detailed information
  • Fetal echocardiogram (echo) to rule out any problems with the heart

Prenatal vs. Postnatal Surgery for Myelomeningocele

If your child has been diagnosed with MMC, our goal is to educate you about your child’s diagnosis and help determine if prenatal surgery is right for you and your baby.

This decision depends largely on your child’s gestational age, the level of the MMC lesion on the spine, the presence of other complications such as Chiari II, and a number of other maternal health factors.

Fetal spina bifida repair requires a significant commitment from mom. If you choose this option, you’ll need to play for a stay in the St. Louis area for a minimum of two weeks, and you will deliver your baby by Cesarean section. Post-birth surgery is also an option. This method allows our surgeons to close the opening of the spinal cord after birth. 

When considering your options, our team will inform you of the benefits and risks of each treatment. We’ll work with you to help you make the best decision for your family.

Long-Term Care for Children with Spina Bifida

At SSM Health Cardinal Glennon Children’s Hospital, a long established spina bifida clinic is available for follow-up care after birth. This specialized clinic is comprised of doctors in multiple specialties and nurses, all dedicated to the continued care of your child.

While we can’t change the diagnosis, we can provide you expert care and support, helping your child get the most out of treatment and life. If you’re facing a diagnosis, schedule an appointment with us at the Cardinal Glennon St. Louis Fetal Care Institute. You may call our team directly at 314-268-4037 or speak with your doctor about the potential of a referral.

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