| In utero repair of myelomeningocele: a comparison of endoscopy and hysterotomy. | |
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MedLine Citation:
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PMID: 10720871 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare endoscopic coverage of myelomeningocele with a maternal split-thickness skin graft in utero to definitive neurosurgical closure through a hysterotomy. METHODS: Four fetuses with isolated myelomeningocele underwent endoscopic coverage of the defect with a maternal split-thickness skin graft in a CO(2) environment at 22-24 weeks' gestation. Subsequently, 4 fetuses underwent standard neurosurgical closure of their myelomeningoceles at 28-29 weeks' gestation. RESULTS: The mean operating time for the endoscopic procedures was 297 +/- 69 min. Two fetal losses occurred as a result of chorioamnionitis and placental abruption, respectively. A third baby delivered at 28 weeks' gestation after prolonged disruption of the membranes. The 2 survivors required standard closure of the myelomeningocele after delivery. The mean operating time for the hysterotomy procedures was 125 +/- 8 min. No mortality occurred, and all the infants delivered between 33 and 36 weeks with well-healed myelomeningocele scars. At present, the functional levels of all infants approximate the anatomical levels of the lesions. CONCLUSION: With current technology, in utero repair of congenital myelomeningocele through a hysterotomy appears to be technically superior to procedures performed endoscopically. |
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Authors:
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J P Bruner; N B Tulipan; W O Richards; W F Walsh; F H Boehm; E K Vrabcak |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Fetal diagnosis and therapy Volume: 15 ISSN: 1015-3837 ISO Abbreviation: Fetal. Diagn. Ther. Publication Date: 2000 Mar-Apr |
Date Detail:
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Created Date: 2000-05-05 Completed Date: 2000-05-05 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9107463 Medline TA: Fetal Diagn Ther Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 83-8 Citation Subset: IM |
Copyright Information:
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Copyright 2000 S. Karger AG, Basel. |
Affiliation:
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Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tenn., USA. joe.bruner@mcmail.vanderbilt.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Endoscopy* Female Fetal Diseases / surgery* Gestational Age Humans Hysterotomy* Meningomyelocele / surgery* Pregnancy Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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