| Fetal surgery for myelomeningocele: progress and perspectives. | |
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MedLine Citation:
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PMID: 21745203 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Myelomeningocele (MMC), one of the most common congenital malformations, can result in severe lifelong disabilities, including paraplegia, hydrocephalus, Chiari II malformation, bowel and bladder dysfunction, skeletal deformations, and neurocognitive impairment. Experimental studies provide compelling evidence that the neurological deficits associated with MMC are not simply caused by incomplete neurulation but rather by the prolonged exposure of the vulnerable neural elements to the intrauterine environment. MMC is the first non-lethal anomaly considered for fetal surgical intervention, necessitating a careful analysis of risks and benefits. Retrospective and prospective randomized studies suggest that fetal surgery of MMC before 26 weeks of gestation may preserve neuromotor function, reverse hindbrain herniation, and reduce the need for ventriculoperitoneal shunting. However, these studies also demonstrate that fetal surgery is associated with significant maternal and fetal risks. Consequently, additional research is necessary to further elucidate the pathophysiology of MMC, to define the ideal timing and technique of fetal closure, and to evaluate the long-term implications of prenatal intervention. |
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Authors:
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Enrico Danzer; Mark P Johnson; N Scott Adzick |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-11 |
Journal Detail:
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Title: Developmental medicine and child neurology Volume: - ISSN: 1469-8749 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0006761 Medline TA: Dev Med Child Neurol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press. |
Affiliation:
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Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia and University of Pennsylvania, School of Medicine, Philadelphia, PA, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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