Under what circumstances would you consider a post-natal myelomeningocele repair rather than a fetal myelomeningocele repair?

There are certain inclusion and exclusion criteria for fetal repair of myelomeningocele. Fetal repair of myelomeningocele is generally offered only to carefully selected singleton pregnancies that meet anatomic, gestational age, maternal, and exclusion criteria based on MOMS and subsequent institutional guidelines. The criteria include:

Anatomic criteria

- Myelomeningocele with upper level between T1 and S1; lesion may extend below S1 but not above T1.

- Evidence of hindbrain herniation (Chiari II) on ultrasound and/or fetal MRI.

- No major additional structural anomalies unrelated to MMC (e.g., major cardiac, renal, or other CNS malformations) that would compromise benefit.

- Normal fetal karyotype and microarray (or otherwise explained, n...