Related Experiment Video
Updated: Aug 11, 2025
Novel Mini-open Transforaminal Lumbar Interbody Fusion
Published on: June 6, 2025
Advances in Fetal Surgical Repair of Open Spina Bifida
Ramen H Chmait1, Martha A Monson, Andrew H Chon
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California; the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Intermountain Healthcare, and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah; and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon.
Insights
Prenatal repair of spina bifida (a neural tube defect) can improve child outcomes. Minimally invasive fetoscopic surgery offers similar benefits with fewer risks to the mother and future pregnancies.
Area of Science:
- Medical Science
- Obstetrics
- Pediatric Surgery
Background:
- Spina bifida is a common birth defect affecting the central nervous system, occurring in 2-4 per 10,000 live births.
- Prenatal screening allows for early detection and management options during pregnancy.
- Traditional open maternal-fetal surgery for spina bifida improves fetal outcomes but carries risks for the mother and future pregnancies.
Purpose of the Study:
- To evaluate the outcomes of minimally invasive prenatal repair of open spina bifida using fetoscopy.
- To compare the risks and benefits of fetoscopic repair versus traditional open surgical repair.
- To assess the impact on the pregnant patient and future childbearing.
Main Methods:
- Review of recent advances in minimally invasive prenatal repair techniques for open spina bifida.
- Comparison of outcomes data between open surgical repair and fetoscopic repair.
- Analysis of maternal and fetal risks associated with each surgical approach.
Main Results:
- Fetoscopic prenatal repair of open spina bifida demonstrates comparable benefits for the child to open surgery.
- Minimally invasive repair shows improved outcomes for the pregnant patient.
- Fetoscopic approach is associated with reduced risks for future pregnancies.
Conclusions:
- Minimally invasive prenatal repair of spina bifida through fetoscopy is a viable alternative to open surgery.
- Fetoscopic repair offers significant advantages for maternal health and reproductive outcomes.
- This approach represents an advancement in managing fetal central nervous system anomalies.
Abstract:
Spina bifida remains a common congenital anomaly of the central nervous system despite national fortification of foods with folic acid, with a prevalence of 2-4 per 10,000 live births. Prenatal screening for the early detection of this condition provides patients with the opportunity to consider various management options during pregnancy. Prenatal repair of open spina bifida, traditionally performed by the open maternal-fetal surgical approach through hysterotomy, has been shown to improve outcomes for the child, including decreased need for cerebrospinal fluid diversion surgery and improved lower neuromotor function. However, the open maternal-fetal surgical approach is associated with relatively increased risk for the patient and the overall pregnancy, as well as future pregnancies. Recent advances in minimally invasive prenatal repair of open spina bifida through fetoscopy have shown similar benefits for the child but relatively improved outcomes for the pregnant patient and future childbearing.
