Evidence on the safety and efficacy of fetoscopic prenatal repair of open neural tube defects in the fetus is inadequate in quantity and quality. Therefore, this procedure should only be used in the context of research. This could be in the form of randomised controlled trials or published registry data. Find out what only in research means on the NICE guidance page.
The procedure is technically challenging and should only be done in specialised centres, and only by clinicians and teams with specific training and experience in fetoscopic prenatal repair.
Patient selection should only be done by a multidisciplinary team, which should include a consultant in fetal medicine, an obstetric surgeon, a paediatric neurosurgeon, a radiologist with experience in fetal imaging and an anaesthetist.
Further research should report details of risks to the mother (including her subsequent pregnancies), risks to the fetus (including the need for further surgery), and long-term disability after birth.