Prognosis for babies with meningomyelocele and high lumbar paraplegia at birth.

The life expectation of babies with paralytic lumbar meningomyelocele not offered immediate surgery at birth appears to be influenced by the extent to which parents are involved in the child's early care. 8 of the 27 children offered family-centred care in one hospital in 1971-80 and not offered immediate surgery survived to school entry and none of these children has since died. All are chairbound and incontinent, but none is intellectually retarded and many are no more handicapped than the children offered immediate surgical treatment at birth. The choice before the family at birth does not have to be presented as an urgent and immediate choice between life and death.