The Big Picture
A year after introducing a groundbreaking approach to fetal surgery for spina bifida, clinicians at Utah’s leading children’s hospitals are marking a milestone: better outcomes for babies, fewer invasive interventions after birth, and a fast-moving future for how complex conditions can be treated before delivery.
Spina bifida (myelomeningocele) is a serious condition that occurs when a baby’s spine and spinal cord don’t form properly during pregnancy. For families, it can mean long-term mobility challenges and ongoing medical needs. For care teams, it has fueled decades of innovation in maternal-fetal medicine—especially around whether earlier treatment can change a child’s trajectory.
What’s Happening
At University of Utah Health and Intermountain Health Primary Children’s Hospital, specialists have continued advancing fetal surgery options for babies who qualify—building on years of progress and recent momentum around less invasive techniques.
Pediatric surgeon Dr. Stephen Fenton first encountered early versions of fetal spina bifida surgery research years ago, when the procedure was still highly experimental. By 2021, teams began offering open fetal surgery locally, and around the same time started expanding capabilities toward a fetoscopic approach—an evolution designed to reduce the size of the incision required for the pregnant parent.
To get there, clinicians learned from institutions already performing the procedure and worked alongside experienced surgeons during initial cases. Now, the team has reached a point where the approach can be performed with confidence and consistency, with outcomes aligned to what clinicians and families hope to achieve.
Why It Matters
The impact of fetal spina bifida surgery is backed by landmark clinical evidence. A major study known as the MOMS Trial (Management of Myelomeningocele Study) found that for babies who qualify, fetal surgery can significantly improve outcomes compared with post-birth repair.
According to Dr. Fenton, key benefits include:
A decreased chance of needing a shunt to drain fluid from the brain
Improved motor function outcomes, meaning some children may gain mobility that would not have been possible otherwise (including walking independently or with less assistance)
Potential implications for bowel and bladder function, which can be major quality-of-life factors over time
In short: treating spina bifida before birth can reduce complications, improve function, and potentially reshape what families can expect in the years ahead.
The Bottom Line
One year in, this milestone represents more than a timeline—it signals where fetal surgery is headed next.
Dr. Fenton believes the future will likely include continued movement toward less invasive techniques, so fetal repair can be performed without large incisions. As instruments and technology improve, teams may be able to do more with less impact on the pregnant parent—while still achieving strong outcomes for the baby.
Looking further ahead, additional innovations may play a role too, including medications or stem-cell-based therapies that could amplify recovery or improve long-term results. As medicine has advanced dramatically over the last century, the next 10 to 20 years in maternal-fetal care may bring even more breakthroughs.
For Utah families, the message is clear: fetal spina bifida surgery isn’t just an emerging option—it’s a rapidly advancing area of care that is already changing lives, and it’s only accelerating from here.