What is the rationale for fetal repair in spina bifida management?

What is the rationale for fetal repair in spina bifida management?

• A. It shields exposed neural tissue from the amniotic environment and allows more time for nervous system development
• B. It accelerates gestation to an earlier birth
• C. It fully prevents hydrocephalus
• D. It eliminates Chiari II malformation

Answer: (A)

Fetal repair is done because the open neural tissue in spina bifida remains exposed to the amniotic environment and can be damaged further as the pregnancy progresses. Covering and closing the defect in utero protects the exposed spinal cord from ongoing mechanical irritation and chemical exposure, which helps stabilize the developing nervous system and gives it more time to mature before birth. This protective effect can translate into better neurological outcomes and may reduce some brain-related issues that accompany the defect, potentially lowering the need for certain postnatal interventions. However, this approach does not guarantee that hydrocephalus will be prevented, nor does it guarantee elimination of Chiari II malformation, and it does carry risks such as prematurity.