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Abstract：
Background and Objectives: Myelomeningocele is the most severe form of spina bifida, a congenital neural tube defect arising from an incomplete neural tube closure during early development with damage worsening with advancing gestational age. The Management of Myelomeningocele Study (MOMS) Trial proved that surgery performed before 26 weeks of gestation significantly improved the prognosis, significantly changing treatment paradigms. This article aims to provide a review of the changes and updates in spina bifida repair over the 10-year period following the MOMS Trial. Material and methods: We performed a systematic review in the PubMed and Cochrane databases as well as a hand-search of high-impact journals using the reference list of all identified articles, searching for randomized controlled trials and observational studies. Results: We identified 27 articles published between 2011 and 2021 that fulfilled the inclusion criteria and review them in the present study. Conclusions: With growing experience and with the improvement of prenatal open and fetoscopic techniques, the outcome of SB-associated conditions could be improved and the risks to both the mother and the fetus reduced. A continuous follow-up of the treated infants and further randomized trials are essential to study the complications and advantages or disadvantages of any given treatment strategy.
摘要：
背景和目的:脊髓膜膨出是最严重的脊柱裂,先天性神经管缺陷是由于早期发育过程中神经管闭合不全引起的，随着胎龄的增加，损伤恶化。脊髓膜膨出治疗研究（MOMS）试验证明，在妊娠26周之前进行的手术显着改善了预后，显著改变治疗模式。本文旨在对MOMS试验后10年期间脊柱裂修复的变化和更新进行综述。材料和方法：我们在PubMed和Cochrane数据库中进行了系统评价，并使用所有已确定文章的参考列表对高影响力期刊进行了手工搜索，寻找随机对照试验和观察性研究。结果：我们确定了2011年至2021年间发表的27篇符合纳入标准的文章，并在本研究中进行了回顾。结论：随着越来越多的经验和产前开放和胎儿镜检查技术的改进，可以改善SB相关疾病的结局,降低母亲和胎儿的风险.对接受治疗的婴儿进行连续随访和进一步的随机试验对于研究任何给定治疗策略的并发症和优缺点至关重要。
