{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T03:19:19Z","timestamp":1785467959437,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T00:00:00Z","timestamp":1635379200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/objectives<\/jats:title><jats:p>Prenatal myelomeningocele (MMC) repair has been shown to improve neurological outcomes. It has been suggested that decreases in the hysterotomy diameter during surgery can improve perinatal outcomes without altering neurologic outcomes. The objective of this study is to describe and compare the main maternal and fetal outcomes of fetuses undergoing open surgery for MMC repair, through the different modifications (standard\u2010classical, mini\u2010hysterotomy, and microneurosurgery).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data source<\/jats:title><jats:p>MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Ovid, SciELO, LILACS, PROSPERO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From a total of 112 studies, seven case series were selected including 399 fetuses with open fetal surgery, five studies using the classical technique (<jats:italic>n<\/jats:italic>\u00a0=\u00a0181), one with mini\u2010hysterotomy (<jats:italic>n<\/jats:italic>\u00a0=\u00a0176), and one with the microneurosurgery technique (<jats:italic>n<\/jats:italic>\u00a0=\u00a042). The mini\u2010hysterotomy and microneurosurgery techniques presented a lower risk of preterm delivery (21.4% and 30%, respectively) compared to the classic technique (47.3%), premature rupture of membranes (78%, 62%, and 72.5 %, respectively), oligohydramnios (0% and 72.5%, respectively), dehiscence of hysterotomy, maintaining the same frequency of Chiari reversion (78%, 62%, and 72.5%, respectively), postnatal correction requirement (0%, 4.8%, and 5.8%, respectively), and lower frequency of requirement for a ventriculoperitoneal shunt placement (13.0%, 7.5%, and 29.1%, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The least invasive techniques (minihysterotomy\u2010microneurosurgery) are possible and reproduceable, as they are associated with better maternal and perinatal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6063","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T04:12:13Z","timestamp":1634875933000},"page":"1615-1623","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Open surgery for in utero repair of spina bifida: Microneurosurgery versus standard technique \u2013 A systematic review"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6019-938X","authenticated-orcid":false,"given":"Saulo","family":"Molina\u2010Giraldo","sequence":"first","affiliation":[{"name":"Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Hospital de San Jos\u00e9, Fundaci\u00f3n Universitaria de Ciencias de la Salud \u2010 FUCS FetoNetwork Colombia  Bogot\u00e1 Colombia"},{"name":"Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology Cl\u00ednica Colsubsidio 94  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Zapata Salcedo","sequence":"additional","affiliation":[{"name":"Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Hospital de San Jos\u00e9, Fundaci\u00f3n Universitaria de Ciencias de la Salud \u2010 FUCS FetoNetwork Colombia  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Rojas Arias","sequence":"additional","affiliation":[{"name":"Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Hospital de San Jos\u00e9, Fundaci\u00f3n Universitaria de Ciencias de la Salud \u2010 FUCS FetoNetwork Colombia  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Acu\u00f1a Osorio","sequence":"additional","affiliation":[{"name":"Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Hospital de San Jos\u00e9, Fundaci\u00f3n Universitaria de Ciencias de la Salud \u2010 FUCS FetoNetwork Colombia  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha Lucia","family":"Pinto Qui\u00f1ones","sequence":"additional","affiliation":[{"name":"Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Hospital de San Jos\u00e9, Fundaci\u00f3n Universitaria de Ciencias de la Salud \u2010 FUCS FetoNetwork Colombia  Bogot\u00e1 Colombia"},{"name":"Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology Cl\u00ednica 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