Which outcome is a potential result of fetal surgery related to hindbrain herniation?

• A. Lower incidence of hindbrain herniation
• B. Increased VP shunt need
• C. No effect on hindbrain herniation
• D. Cure spina bifida completely

Answer: (A)

Fetal repair of a myelomeningocele can change hindbrain positioning by closing the opening early and improving CSF dynamics, which reduces downward displacement of brain structures. Because hindbrain herniation (Chiari II malformation) is driven in part by ongoing CSF leakage and neural tissue exposure, repairing the defect before birth lowers the chance that the hindbrain will herniate by birth. Thus, a potential outcome of fetal surgery is a lower incidence of hindbrain herniation. This intervention may also reduce subsequent hydrocephalus and the need for VP shunting, but it does not cure spina bifida completely, and it does not imply no effect on hindbrain herniation—the observed effect is a reduction, not elimination.