• Jena L Miller and Huisman Thierry A G M TAGM Edward B. Singleton Department of Radiology, Texas Children's Hospital, 6701 Fannin Street, Suite 470, Houston, TX 77030, USA..
• Department of Gynecology and Obstetrics, Johns Hopkins University, 600 North Wolfe Street, Nelson 228, Baltimore, MD 21287, USA. Electronic address: jmill260@jhmi.edu.
• Neuroimaging Clin. N. Am. 2019 Aug 1; 29 (3): 357-366.

AbstractFetal spina bifida, the most common nonlethal birth defect of the central nervous system, results in substantial neurologic morbidity. The unified theory describes the complex relationship between local spinal lesions and development of Chiari 2 malformation, contributing to hydrocephalus. Prenatal ultrasonography reliably allows diagnosis, but fetal MR imaging is an important complement to identify additional brain abnormalities. Fetal surgery improves neurologic and motor outcomes, but various approaches, either open hysterotomy or minimally invasive to the uterus, carry substantial obstetric risks. Optimization of the fetoscopic approach aims to minimize maternal and obstetric risks, but data regarding longer-term outcomes are awaited.Copyright © 2019 Elsevier Inc. All rights reserved.

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