FETAL SURGERY FOR TREATMENT OF NEURAL TUBE DEFECTS: OBSTETRIC APPROACH AND POSTNATAL NEUROLOGICAL EVALUATION

Abstract

Introduction: Fetal surgery has emerged as an innovative approach in the treatment of neural tube defects, which include conditions such as spina bifida. These defects, resulting from a failure of the neural tube to close during embryonic development, can lead to serious neurological consequences. Surgical intervention performed in utero allows the correction of anomalies and improves the neurological prognosis of the child. Obstetric strategies and postnatal evaluations have proven crucial in understanding the long-term effects of these interventions. Thus, current practices include a combination of prenatal care, advanced surgical techniques, and rigorous neurological evaluations to optimize outcomes. Objective: To review the existing literature on the outcomes of fetal surgery for neural tube defects, focusing on obstetric approaches and neurological evaluations performed after birth. Methodology: The methodology followed the PRISMA checklist guidelines, using databases such as PubMed, Scielo and Web of Science. Five main descriptors were used: "fetal surgery", "neural tube defects", "neurological evaluation", "prenatal treatment" and "postnatal outcomes". The search was conducted on articles published in the last ten years. The inclusion criteria were: clinical studies that addressed fetal surgical interventions, analyses of postnatal neurological outcomes and peer-reviewed publications. Exclusion criteria included articles that were not available in full text, reviews that did not specifically focus on fetal surgery and studies with samples smaller than ten patients. Results: Data analysis revealed that fetal surgery significantly reduced the severity of neurological sequelae associated with neural tube defects. An improvement in motor and cognitive functions was observed in childhood, in addition to a reduction in complications associated with childbirth. Conclusion: Fetal surgery for the treatment of neural tube defects represents a significant advance in obstetric and pediatric medicine. The results suggest that early intervention can lead to remarkable improvements in children's neurological conditions. Continuity of care and rigorous assessments are essential to maximize the benefits of this approach, highlighting the need for interdisciplinary care throughout the lifespan.