Selective treatment of myelomeningocele: To treat or not to treat?

There never was and perhaps never will be a really satisfactory method of treatment for infants born with severe myelomeningocele, nor for the management of their families, in spite of the best technical advances and the most humane attempts. The best hope for the future lies in prevention of conception of such infants, but we are far from that. The next best hope is early antenatal diagnosis so that at least we can prevent the birth of such infants. The recent discovery that abnormally high levels of alpha-fetoprotein are present in the amniotic fluid of women carrying an infant with spinal or cranial dysraphism has already been put to routine practical use.