Fetoscopic myelomeningocoele closure: Is the scientific evidence enough to challenge the gold standard for prenatal surgery? |
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| Authors: | E Joanne Verweij Martine C de Vries Esther J Oldekamp Alex J Eggink Dick Oepkes Femke Slaghekke Jochem K H Spoor Jan A Deprest Jena L Miller Ahmet A Baschat Philip L J DeKoninck |
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| Institution: | 1. Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands;2. Department of Medical Ethics 3. & Health Law, Leiden University Medical Center, Leiden, The Netherlands;4. Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands;5. Department of Neurosurgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands;6. Academic Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium;7. Johns Hopkins Center for Fetal Therapy, Department of Gynecology 8. & Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA |
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| Abstract: | Since the completion of the Management of Myelomeningocoele Study, maternal-fetal surgery for spina bifida has become a valid option for expecting parents. More recently, multiple groups are exploring a minimally invasive approach and recent outcomes have addressed many of the initial concerns with this approach. Based on a previously published framework, we attempt to delineate the developmental stage of the surgical techniques. Furthermore, we discuss the barriers of performing randomized controlled trials comparing two surgical interventions and suggest that data collection through registries is an alternative method to gather high-grade evidence. |
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