Which outcome is a potential result of fetal surgery related to hindbrain herniation?

Which outcome is a potential result of fetal surgery related to hindbrain herniation?

• A. Lower incidence of hindbrain herniation
• B. Increased VP shunt need
• C. No effect on hindbrain herniation
• D. Cure spina bifida completely

Answer: (A)

Fetal surgery for myelomeningocele can change the CSF dynamics between the brain and spinal cord. By repairing the open spinal defect before birth, the abnormal pressure that drives hindbrain downward herniation (Chiari II) is reduced, leading to a lower incidence of hindbrain herniation after the procedure.

This is the best-supported outcome because the repair helps normalize the forces affecting the hindbrain, making descent less likely. It’s not primarily about increasing the need for a VP shunt—actually, some data suggest shunt requirements may decrease after prenatal repair, though this varies by case. It certainly does not cure spina bifida completely; the defect and associated risks can persist despite fetal intervention.