Hi! If your wife was my patient, I would recommend a level 3 scan ASAP. A fetal MRI might also be useful.
A meningomyelocele is a condition caused by failure of the baby's lower spine to develop normally, so that part of the spinal cord and covering membranes are actually exposed. Depending upon the severity of the condition, this can lead to difficulty in movement of the baby's lower limbs.
A triple marker test done in the second trimester of pregnancy should show an elevated AFP level if the baby has a meningomyeloceole. In most cases the level is quite elevated, and not subtle, however, there are false negative tests.
A meningomyelocele would also be present from conception and would not develop later in pregnancy--in other words, it should have been noted on an earlier scan--although there are false negative ultrasound scans too.
It sounds to me as though your doctors are suspecting a teratoma instead of a meningomyeolcele. A teratoma is a type of tumor which is almost always benign and could potentially be completely surgically removed without complications.
More sophisticated ultrasound or MRI could potentially help to sort out the differential diagnosis before delivery. One thing I would certainly look at is the presence or absence of movement of the lower limbs. That should be easy to see regardless of the technology.
In the US, we would almost certainly perform a cesarean section for the delivery. A planned delivery at term would be ideal so that neonatologists could be present to evaluate the needs of the newborn.
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