Necessity of Diagnostic Testing for ONTD Fetoscopic Surgical Candidacy

Jessica Scarlett, BS (Advisor: Blair Stevens, MS, CGC)

          This retrospective chart review of spina bifida referrals from 2016 - 2025 evaluated over 300 referrals in order to explore the utility of amniocentesis as a requirement for prenatal surgical repair of spina bifida. In our isolated spina bifida cohort, there were a total of 18 surgical candidates with abnormal genetic testing or normal afAFP/AchE results: eight cases with abnormal genetic results, four cases with negative AchE results, and six cases with negative afAFP.  There were no cases where genetic testing results alone precluded the patient from receiving fetal surgery. Patients with private insurance were 2.566 times more likely than patients with government insurance to be candidates (p = 0.03). Patients with government insurance were scheduled for their first candidacy appointment an average of three days (23w0d versus 23w3d) later than patients with private insurance (p = 0.0.0017). We assert that spina bifida surgical candidacy should be determined based on individualized decision-making and the amniocentesis requirement be reconsidered as it may be an unnecessary barrier to surgery disproportionately affecting patients with government health insurance.

Advisory Committee:

• Blair Stevens, MS, CGC, Chair
• Luana Goulet, MS, CGC
• Hope Northrup, MD
• Rosemary Rogers, MS, CGC
• Theresa Wittman, MS, CGC 

Join via Microsoft Teams (Please contact Ms. Scarlett for her microsoft teams meeting info.)