Open fetal surgery for myelomeningocele repair in France
| Autor: | Pauline Lallemant, Véronique Forin, Mohamed-Ali Lachtar, Paul Maurice, Ferdinand Dhombres, Michel Zerah, Timothée De Saint-Denis, Catherine Garel, Lucie Guilbaud, Federico Di Rocco, A. Rigouzzo, Marie-Laure Moutard, Emeline Maisonneuve, Stéphanie Friszer, Jean-Marie Jouannic |
|---|---|
| Přispěvatelé: | Service de Médecine Fœtale [CHU Trousseau], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), Service de Neuropédiatrie [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service de réanimation néonatale et pédiatrique [CHU Trousseau] |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Meningomyelocele Dysraphism Open maternal fetal surgery Myeloschisis [SDV]Life Sciences [q-bio] medicine.medical_treatment Population Dehiscence 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans education Spina bifida Fetal surgery education.field_of_study Fetus 030219 obstetrics & reproductive medicine business.industry Fetoscopy Obstetrics and Gynecology Gestational age medicine.disease 3. Good health Surgery Fetal Diseases Reproductive Medicine 030220 oncology & carcinogenesis Female Myelomeningocele business Complication Premature rupture of membranes |
| Zdroj: | Journal of Gynecology Obstetrics and Human Reproduction Journal of Gynecology Obstetrics and Human Reproduction, Elsevier, 2021, pp.102155. ⟨10.1016/j.jogoh.2021.102155⟩ |
| ISSN: | 2468-7847 |
| Popis: | International audience; Introduction: - Open fetal myelomeningocele (MMC) surgery is currently the standard of care option for prenatal MMC repair. We described the population referred to our center and reviewed outcome after open fetal MMC repair.Material and methods: - All patients referred to our center for MMC were reviewed from July 2014 to June 2020. For all the patients who underwent fetal MMC repair, surgical details, maternal characteristics and data from the neonatal to the three-years-old evaluations were collected.Results: - Among the 126 patients referred to our center, 49.2% were eligible and 27.4% (n=17) of them underwent fetal MMC repair. Average gestational age at fetal surgery was 24+6 weeks. There was no case of fetal complication and the only maternal complication was one case of transfusion. We recorded 70% of premature rupture of membranes and 47% of premature labor. Average gestational age at delivery was 34+2 weeks and no patient delivered before 30 weeks. There was no case of uterine scar dehiscence or maternal complication during cesarean section. After birth, 59% of the children had a hindbrain herniation reversal. At 1-year-old, 42% were assigned a functional level of one or more better than expected according to the prenatal anatomic level and 25% required a ventriculoperitoneal shunt. At 3-year-old, all the children attended school and 75% were able to walk with orthotics or independently.Conclusion: - Open fetal surgery enables anatomical repair of the MMC lesion, a potential benefit on cerebral anomalies and motor function, with a low rate of perinatal and maternal complications. |
| Databáze: | OpenAIRE |
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