Abstract

Fetal surgery for open spina bifida is the treatment of choice for fetuses with this malformation. How-ever, 14 years after its global implementation, its recognition in Chile remains limited, even among specialists such as obstetrician-gynecologists, neonatologists, and neurosurgeons. Objective: To syn-thesize current evidence on fetal surgery for spina bifida, its clinical outcomes, and applicability in the national context. Methods: Narrative literature review based on a non-systematic search of original articles, reviews, and clinical guidelines in academic databases (PubMed, Web of Science, SciELO), using key terms related to in utero/fetal surgery for spina bifida. Results: Fetal surgery for spina bifida showed significant benefits over postnatal management by reducing the need for ventriculoperito-neal shunting and improving motor function. In Chile, despite existing experience, implementation barriers persist, including limited access to specialized multidisciplinary teams and adequate funding. Conclusions: Fetal surgery for spina bifida should be considered the gold standard for eligible fetuses. Health authorities must ensure its availability in both public and private healthcare systems, guaran-teeing the fundamental right of access to this therapy, which improves the quality of life of patients, their families, and society. © 2025, Sociedad Chilena de Pediatria. All rights reserved.