In utero surgery versus the diagnosis of spina bifida

Abstract

During the normal development of the central nervous system, congenital defects can occur, such as spina bifida, resulting from the incomplete development of the neural tube between the third and fourth gestational weeks. As corrective methods, two techniques have been developed: postnatal surgery and in utero or prenatal surgery. The latter exposes the fetal neural tube and corrects its premature closure, and is performed in the early weeks of gestation. Diagnosis is primarily made through prenatal ultrasound and laboratory tests, such as alpha-fetoprotein. The focus is on identifying the benefits of in utero surgery treatment compared to the diagnosis of spina bifida. A scoping review of the literature was conducted. Inclusion and exclusion criteria were established for the bibliographic search, which was carried out in scientific databases such as Scopus, PubMed, ScienceDirect, and Springer Link. Each article to be used was added to the bibliographic management tool Zotero. The results highlighted the benefits of applying in utero surgery in fetuses diagnosed with spina bifida, in relation to the development of complications and physical and psychological limitations that this condition can cause. The application of in utero surgery in patients has significantly improved their quality of life, reducing mortality and complications related to neurological, motor, and sphincter issues, as well as additional medical interventions like ventriculoperitoneal shunting and invasive surgeries for the children.