What Is Myelomeningocele?
Myelomeningocele is the most severe form of tethered cord/spina bifida. It is also called Open Neural Tube Defect (ONTD).
ONTD is when the spinal cord forms outside the body at the surface of the skin. This condition needs to be closed quickly after birth to avoid infections and any further brain or spinal injury. ONTD is associated with brain abnormalities, known as Chiari II. About 60-80% of cases are associated with hydrocephalus, which is a buildup of fluid in the brain.
Diagnosing Open Neural Tube Defect (ONTD)
Your OB/GYN will likely detect ONTD through routine screenings at prenatal appointments.
Prenatal screenings may include:
- Blood test, which screens for proteins in the blood that indicate myelomeningocele ONTD
- Ultrasound, which can show an image of your baby’s spine and organs
- Test of amniotic fluid that screens for proteins that indicate ONTD
If your care team suspects ONTD, your obstetrician will refer you to a maternal-fetal medicine doctor, who has extra training in treating fetal conditions.
At University Health, you will feel confident with your care team. We are a state-designated Level IV (the highest level) maternal care facility with experienced, board-certified specialists.
Our Women’s & Children’s Hospital is also a regional perinatal referral center for South Texas. That means you’ll have 24/7 access to advanced imaging technology, a dedicated Women’s Center for OB/GYN emergencies.
Treatment Options
Childbirth and Delivery
If your baby has ONTD, your delivery team will likely recommend a C-section to reduce the risk of spinal cord injury during birth. If your baby has a more severe form of ONTD, they will be transferred to the neonatal intensive care unit (NICU) for observation and infection prevention.
Surgery
Your doctors will recommend surgery to close the spinal defect, correct a tethered cord or treat hydrocephalus.
Your care team will discuss all treatment options available to you so you can make an informed decision.
ONTD Risk Factors
Risk factors for the mother include:
- Already having a child with ONTD. The risks of having another child with this condition increase significantly after the first.
- A history of miscarriages
- Unmanaged diabetes
- Infection during pregnancy
- Drug or alcohol use during pregnancy
- Low folic acid levels
- Maternal diabetes
Outlook & Living with ONTD
There are some cases where your child may need lifelong follow-up care from a team of specialists, which may include:
- Neurosurgeon, who can monitor your child’s condition and determine if they require additional corrective procedures
- Urologist, who help manage incontinence and UTIs
- Orthopedic surgeon, who may correct clubfoot
- Physical medical and rehabilitation (PM&R)
Your University Health care team is here to ensure you and your baby are provided comprehensive care before, during and after birth.