**6.3 Intrauterine myelo-meningocele (IMM)**

IMM, or Spina bifida, is defined as failure of complete closure of the neural tube with exposure of the spinal canal structures. Lumbar or cervical vertebral levels are the most commonly affected sites, however IMM can occur anywhere along the spine. Neurologic deficits with motor and somato-sensory abnormalities are the most feared complications. In addition, bowel and bladder function may be affected due to injury of autonomic nervous system. Moreover, mostly all patients with IMM will develop Arnold-Chiari II malformation affecting hindbrain, with non-communicating hydrocephalus, which requires ventriculo-peritoneal shunting. Although mortality of IMM was low in the perinatal period, its long-term neurologic morbidity may be fatal, and up to 30% of patients may die before adulthood [57–60].
