Avoiding the antenatal counselling faux pax: Bridging the gap between prenatal prognostication and postnatal outcome. 

Purpose: Closed spina bifida (CSB) is rare in prenatal literature and various lesions are grouped under this broad nosological entity CSB, leading to confusing and misleading prognostic conclusions. Methods This is a retrospective observational cohort study of prenatally detected CSB cases using two-dimensional ultrasound, complemented by three-dimensional ultrasonography and fetal MRI in indicated cases, from October 2014 to October 2021 in a tertiary level single centre. Results The most common upper vertebral level of CSB was lumbar in 66.6% (10/15). The sub-classification of lesions based on prenatal ultrasound showed an agreement in 53% of the cases. 60% had associated abnormalities identified postnatally, the most common being anorectal malformation seen in 33.3%. On postnatal follow-up, 46.6% had bowel incontinence and bladder dysfunction, 33.3% developed lower limb deformities. Conclusions All CSBs do not have a uniformly favourable prognosis. The prognosis of CSB depends on the pathological type, the presence of associated abnormalities and the management.