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BACKGROUND: Currently, maternal-fetal surgery for repair of myelomeningocele requires an upper-segment hysterotomy, which likely increases maternal postsurgical risks. If fetoscopic repair of myelomeningocele achieves similar or better fetal outcomes while decreasing maternal risks, it would be a better option.

CASE: A patient with a fetus with a L3-S1 meningomyelocele underwent a laparotomy and fetoscopic repair using a two-port, in-CO2 approach at 23 2/7 weeks of gestation. The neonate was delivered at 30 6/7 weeks of gestation by lower segment cesarean delivery and required no further surgery, has not needed a shunt (5 months), and has normal, age-appropriate neurologic function.

CONCLUSION: This innovative fetoscopic approach may offer an alternative to open fetal surgery and may prevent the need for hysterotomy and cesarean delivery in index and subsequent pregnancies.

(C) 2015 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.