Fetoscopic Neural Tube Defect Repair

Inclusion Criteria: * Maternal age 18 years or older * Capable of consenting for their own participation in the study * Decision to have fetoscopic repair following counseling of all options * Open spina bifida with the upper boundary between T1 and S1 * Gestational age between 24 0/7 to 26 6/7 weeks' gestation at the time of surgery * Normal karyotype and/or normal chromosomal microarray by invasive testing. In the case of a microdeletion, microduplication, or variant of uncertain significant, the decision to include or exclude will be at the discretion of the Principal Investigators. * Absence of major cardiac anomalies confirmed by fetal echocardiogram * Adequate social support throughout pregnancy * Parental or guardian willingness to undergo follow-up evaluations of the child after birth Exclusion Criteria: * Multiple gestation * Major fetal anomalies unrelated to the neural tube defect * Kyphosis in fetus of 30 degrees or more as assessed by ultrasound or MRI * Previous spontaneous singleton preterm birth prior to 37 weeks * Presence of cervical cerclage at the time of surgery or history of cervical insufficiency * Cervical length less than 20 mm by endovaginal ultrasound * Placenta previa or evidence of placental abruption * Technical factors such as large uterine fibroids, uterine anomalies, or fetal membrane separation for which the risks of surgery are deemed to outweigh the benefits * Maternal obesity precluding surgical access with a BMI \> 45 or if the Princip…