Fetal closure of an MMC is technically more challenging than the standard postnatal closure. The access is smaller, the structures are smaller and more delicate, the placode must be handled with more care, avoiding blood loss is critical, and the surgery must be performed quickly to limit the exposure of the fetus to the extrauterine environment.

Myelomeningocele (MMC) poses a diagnostic and therapeutic challenge. A thorough and detailed examination of the entire fetus, with visualization of every spinal segment, is necessary.

Before the start of the Management of Myelomeningocele Study (MOMS) in 2003, an initial group of 58 patients at CHOP underwent in utero repair of their myelomeningocele between 21 and 25 weeks' gestation. Urologic results after fMMC repair are discussed here.

The CFDT Center at CHOP recently reviewed outcomes for fetal MMC repair since the MOMS results were reported, from referral and evaluation through surgery, delivery and neonatal discharge.

Congenital anomalies such as spina bifida can result in a wide range of urologic disorders and necessitate comprehensive, long-term management.

Read the findings of Dr. Rychik's study that investigated the cardiovascular consequences of lower urinary tract obstructions LUTO in the fetus.

Bladder exstrophy is a severe developmental disorder in which the bladder protrudes inferior to umbilical cord insertion and separation of the pubic bones results in divergence of the rectus muscles.

Proper diagnosis of LUTO, treatment and follow-up require an experienced, multidisciplinary team that understands not only the pathogenesis of this condition but also the best options for treatment.

Read about a research study conducted by the Fetal Diagnosis Program at CHOP that focused on maternal psychological stress after prenatal diagnosis of CHD.

Read the case study of a 23-year-old woman carrying a baby with pericardial teratoma and the open fetal surgery that saved her unborn baby's life.