| Fetal Surgery for Myelomeningocele: Patient Selection, Perioperative Management and Outcomes. | |
| | |
MedLine Citation:
|
PMID: 21849764 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
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 of the neurologic deficit associated with MMC is not simply incomplete neurulation but rather chronic mechanical injury and amniotic fluid-induced chemical trauma that progressively damages the exposed neural tissue during gestation. Case series and a prospective, randomized study show that fetal surgery for MMC before 26 weeks' gestation may preserve neurologic function, reverse the hindbrain herniation of the CM-II and obviate the need for postnatal placement of a ventriculoperitoneal shunt. However, these studies also demonstrate that fetal surgery is associated with significant maternal and fetal risks. Consequently, further research is warranted to further expand our understanding of the pathophysiology of MMC, to evaluate the long-term impact of in utero intervention and to refine the timing and technique of fetal MMC surgery. |
| | |
Authors:
|
Enrico Danzer; N Scott Adzick |
Related Documents
:
|
11704204 - Successful digoxin therapy of fetal supraventricular tachycardia in a triplet pregnancy. 21443494 - The clinical utility of the protamine 1/protamine 2 ratio in sperm. 8537854 - Ultrasonographic growth measurements in triplet pregnancies. 11278234 - Three blastocyst stage embryo transfer resulting in a quintuplet pregnancy. 16803554 - Extrauterine choriocarcinoma of the greater omentum after tubal pregnancy: case report. 3953704 - Variable decelerations during nonstress tests are not a sign of fetal compromise. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-8-18 |
Journal Detail:
|
Title: Fetal diagnosis and therapy Volume: - ISSN: 1421-9964 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
|
Created Date: 2011-8-18 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9107463 Medline TA: Fetal Diagn Ther Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2011 S. Karger AG, Basel. |
Affiliation:
|
The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia and The University of Pennsylvania School of Medicine, Philadelphia, Penn., USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Double Unfurled Dartos Flap Technique in the Surgical Treatment of Recurrent Urethrocutaneous Fistul...
Next Document: Current Experience and Prospect of Internet Consultation in Fetal Cardiac Ultrasound.