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Prenatal myelomeningocele has rapidly become the most common in-utero surgery performed following the results of the multi-center, myelomeningocele study. In-utero surgery has greatly improved the prognosis of babies with spina bifida or myelomeningocele. The eligibility criteria for this surgery has also evolved as some centers are now operating on mothers with increased body mass index (BMI). A BMI greater than 40 was not incorporated into the original study. In addition, fetoscopic repair of the myelomeningocele is also being performed, allowing for a decrease in the risk for uterine dehiscence and also offering mothers the opportunity to have a vaginal delivery following in-utero surgery.