Does caesarean section delivery improve neurological outcome in open spina bifida?

The antenatal diagnosis of fetuses with myelomeningocele (MMC) has focused the attention of those involved in the perinatal care on caesarean section delivery as a possible method of preserving neurological function. In this paper 25 infants with MMC were studied, 10 delivered by pre-labour caesarean section (PL C/S), and 15 by other methods. No difference in motor function was observed post natally with 50% of each group having neurological levels below L3. The PL C/S group was more heterogeneous. The feasibility of selecting a group of less impaired fetuses with good in utero leg movements for PL C/S in order to preserve neurological function depends on the ability of fetal USS to predict post natal neurological function. This preliminary report leaves unanswered the question whether C/S delivery improves neurological outcome in selected cases of open spina bifida.