Current controversies in prenatal diagnosis 1: in utero therapy for spina bifida is ready for endoscopic repair.

Abstract

What's already known about this topic? There is level 1 (RCT) evidence for improved neurological outcomes after open fetal surgery for spina bifida versus postnatal surgery. There is a lack of standardization of techniques and comparative outcome data in clinical trials for endoscopic fetal surgery for spina bifida. What does this study add? Different techniques, their strengths, limitations and clinical implications of endoscopic versus open fetal surgery for spina bifida are discussed. Open fetal surgery anticipates postnatal surgery, whereas novel and less invasive endoscopic approaches aim to simplify the technique. More data on long‐term follow‐up of intrauterine closure of spina bifida are needed, and open surgery is one step ahead of fetoscopic approaches.