Fetal surgery for myelomeningocele: trials and tribulations

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Fetal surgery for myelomeningocele?

The possibility of surgical repair of fetal anomalies in utero has long tantalized obstetricians and pediatric surgeons, especially since the development of high-resolution real-time ultrasonography. The presumption has been that earlier in utero repair would provide superior outcomes for the offspring than would postnatal surgery. However, postnatal treatment is much simpler and is not traumat...

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Bladder Function After Fetal Surgery for Myelomeningocele.

BACKGROUND A substudy of the Management of Myelomeningocele Study evaluating urological outcomes was conducted. METHODS Pregnant women diagnosed with fetal myelomeningocele were randomly assigned to either prenatal or standard postnatal surgical repair. The substudy included patients randomly assigned after April 18, 2005. The primary outcome was defined in their children as death or the need...

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Fetal surgery for myelomeningocele: patient selection, perioperative management and outcomes.

Myelomeningocele (MMC), one of the most common congenital malformations, can result in severe lifelong disabilities,including paraplegia, hydrocephalus, Chiari II malformation(CM-II), incontinence, sexual dysfunction, skeletal deformations and mental impairment. MMC was the first nonlethal anomaly to be treated by fetal surgery. Experimental and clinical evidence suggests that the primary cause...

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ژورنال

عنوان ژورنال: Journal of Pediatric Surgery

سال: 2012

ISSN: 0022-3468

DOI: 10.1016/j.jpedsurg.2011.11.021