Document Detail


In utero repair of myelomeningocele: a comparison of endoscopy and hysterotomy.
MedLine Citation:
PMID:  10720871     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J P Bruner; N B Tulipan; W O Richards; W F Walsh; F H Boehm; E K Vrabcak
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Fetal diagnosis and therapy     Volume:  15     ISSN:  1015-3837     ISO Abbreviation:  Fetal. Diagn. Ther.     Publication Date:    2000 Mar-Apr
Date Detail:
Created Date:  2000-05-05     Completed Date:  2000-05-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9107463     Medline TA:  Fetal Diagn Ther     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  83-8     Citation Subset:  IM    
Copyright Information:
Copyright 2000 S. Karger AG, Basel.
Affiliation:
Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tenn., USA. joe.bruner@mcmail.vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
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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