症例 challenge · Imaging / Fetal medicine / Pediatric neurosurgery · teaching

Open Spina Bifida · Fetal Surgery Candidacy (MOMS) · case challenge

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Case #1Imaging / Fetal medicine / Pediatric neurosurgery

📋 Case data

Fetal surgery candidacy assessment (MOMS)Meets MOMS: upper level T1–S1, hindbrain herniation present, 19.0–25.9 weeks, singleton, normal karyotype, no exclusion factors

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Step 1 / 1 · Fetal surgery candidacy assessment (MOMS)

Open spina bifida — fetal surgery candidacy assessment (MOMS)?

💡 Open spina bifida (myelomeningocele/myeloschisis) usually with Chiari II/hindbrain herniation (CSF leak → hindbrain descent → hydrocephalus); the two-hit hypothesis. US + MRI diagnosis (define the upper level of the lesion, confirm hindbrain herniation/Chiari II, ventriculomegaly, exclude associated anomalies). MOMS: in-utero repair <26 weeks reduces death/shunting, reverses hindbrain herniation, improves motor function (2+ levels better than the anatomic level).

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.