Surgical approaches to in-utero spina bifida repair: a Systematic Review

Objective. In the last decade, various surgical approaches have been proposed for the in-utero correction of fetal open spina bifida with variants of the classic hysterotomy technique, aimed at reducing maternal invasiveness and in an attempt to preserve the fetal benefits of the treatment. The aim of our systematic literature review is to analyze the fetal and maternal outcomes of the different surgical techniques available, describing their rationale, advantages and disadvantages. Materials and Methods. The MEDLINE PubMed, Web of Science and EMBASE databases were searched using some keywords, alone or in different combinations. Results. Given the absence of randomized studies and long-term outcome data, it is not possible today to argue the superiority of one technique over the other. Conclusions. Probably both main techniques (open and fetoscopic) are destined to establish themselves with diversified indications based on the specificities of each clinical case.