Evidence map›Paper›PMID 40779058›Full record

SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025

Open repair versus fetoscopic fetal surgery: Which is the best approach for intrauterine myelomeningocele correction? Systematic review and meta-analysis.

Jairo Porfírio de Oliveira Júnior, Bárbara Albuquerque Morais, Matheus Neves Faria Fernandes, Otávio Augusto de Paula Mendes Teixeira, Aloisio Oliveira Lacerda, Milena Vieira Ramos, Rodrigo Akira Watanabe, Paulo Ronaldo Jubé Ribeiro

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Fetal myelomeningocele repair after the MOMS trial: a systematic review of neurosurgical outcomes and evolving techniques.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025
    Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jairo Porfírio de Oliveira JúniorDivision of Neurosurgery, Department of Surgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil. jairopoj@gmail.com.
Bárbara Albuquerque MoraisDivision of Neurosurgery, Department of Surgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil.
Matheus Neves Faria FernandesDivision of Neurosurgery, Department of Surgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil.
Otávio Augusto de Paula Mendes TeixeiraDivision of Neurosurgery, Department of Surgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil.
Aloisio Oliveira LacerdaDivision of Neurosurgery, Department of Surgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil.
Milena Vieira RamosFaculty of Medicine, University of Rio Verde, Goiás, Brazil.
Rodrigo Akira WatanabeDepartment of Neurology and Neurosurgery, Translational Neurosurgery Laboratory Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil.
Paulo Ronaldo Jubé RibeiroDivision of Neurosurgery, Department of Surgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe Management of Myelomeningocele Study in 2011 the prenatal approach has become the gold standard for the correction of myelomeningocele. Since then, advancements in minimally invasive techniques, including fetoscopic repair, have aimed to minimize maternal complications while maintaining fetal benefits.This systematic review and meta-analysis examines the maternal and neonatal outcomes of open versus fetoscopic myelomeningocele repair in utero.

methodsWe systematically searched PubMed and LILACS databases for studies published between 2011 and 2024, following PRISMA guidelines. Data on maternal and fetal outcomes were extracted and analyzed. A total of 32 studies were included.

resultsRegarding maternal and fetal complications in open and fetoscopic surgery, the rates were respectively: premature rupture of membranes (0.298 95% CI: 0.202-0.393 vs. 0.522 95% CI: 0.254-0.790), oligohydramnios (0.145 95% CI: 0.086-0.203; vs. 0.488 95% CI: 0.162-0.813), premature placental abruption (0.032 95% CI: 0.015-0.048 vs. 0.042 95% CI: 0.0-0.084), birth weight (2261.330 g 95% CI: 2125.819-2369.84; vs. 2251.531 g 95% CI: 1845.674-2657.389), prematurity < 37 weeks (0.789 95% CI: 0.729-0.849 vs. 0.636 95% CI: 0.208-1.064), neonatal sepsis (0.097 95% CI: 0.030-0.163 vs. 0.251 95% CI: 0.046-0.455), surgical time (133.7 min 95% CI: 92.070-175.394 vs. 220.4 min 95% CI: 194.264-246.607), neonatal surgical wound dehiscence (0.043 95% CI: 0.023-0.064 vs. 0.137 95% CI: 0.052-0.222), hydrocephalus (0.422 95% CI: 0.256-0.588 vs. 0.391 95% CI: 0.272-0.510), reversal of brainstem herniation (0.601 95% CI: 0.385-0.816 vs. 0.581 95% CI: 0.356-0.806), maintenance or improvement in motor function (0.809 95% CI: 0.692- 0.927 vs. 0.856 95% CI: 0.734-0.978). Only neonatal sepsis in the fetoscopic surgery group was not statistically significant (p < 0.05).

conclusionsThe open approach, traditionally associated with better fetal outcomes, showed better outcomes for maternal complications compared to fetoscopic surgery.

Indexed as

Fetal DiseasesFetoscopyMeningomyeloceleFemaleHumansInfant, NewbornPregnancyFetal neurosurgeryFetoscopicMeta analysisMyelomeningoceleOpen repairSpina bifida

Identifiers

PMID40779058

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.