| Fetal myelomeningocele repair: short-term clinical outcomes. | |
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MedLine Citation:
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PMID: 14520222 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The study was undertaken to evaluate short-term clinical outcomes with antenatal myelomeningocele (MMC) repair. STUDY DESIGN: Retrospective review of 50 fetuses that underwent open fetal MMC closure was performed. Inclusion criteria included less than 26 weeks' gestation, thoracic to S1 level defect, absent clubfoot deformity, Arnold-Chiari malformation, ventriculomegaly less than 17 mm, normal karyotype, and no other anomalies. RESULTS: Perinatal survival was 94% (47/50 fetuses). Mean age at delivery was 34 weeks 3 days. All fetuses demonstrated reversal of hindbrain herniation. Forty-three percent of the 50 fetuses have required ventriculoperitoneal shunting compared with 100% thoracic, 88% lumbar, and 68% sacral (85% overall) in 297 historic controls. Better-than-predicted leg function was seen in 57% of thoracic and lumbar level lesion patients. CONCLUSION: Early experience with fetal MMC repair suggests a decreased need for ventriculoperitoneal shunting, arrest or slowing of progressive ventriculomegaly, and consistent resolution of hindbrain herniation. However, further long-term follow-up is needed to evaluate neurodevelopment and bladder and bowel function. |
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Authors:
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Mark P Johnson; Leslie N Sutton; Natalie Rintoul; Timothy M Crombleholme; Alan W Flake; Lori J Howell; Holly L Hedrick; R Douglas Wilson; N Scott Adzick |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 189 ISSN: 0002-9378 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2003 Aug |
Date Detail:
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Created Date: 2003-10-01 Completed Date: 2003-10-23 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 482-7 Citation Subset: AIM; IM |
Affiliation:
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Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadephia, PA 19104, USA. johnsonma@email.chop.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Delivery, Obstetric Female Fetal Diseases / physiopathology, surgery* Gestational Age Humans Infant Mortality Infant, Newborn Leg / physiopathology Lumbosacral Region Meningomyelocele / embryology*, physiopathology, surgery* Pregnancy Pregnancy Outcome Reoperation Retrospective Studies Survival Analysis Thorax Time Factors Treatment Outcome Ventriculoperitoneal Shunt |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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