Document Detail


Myelomeningocele: prenatal diagnosis, pathophysiology and management.
MedLine Citation:
PMID:  12961110     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Myelomeningocele (MMC) is a common birth defect that is associated with significant lifelong morbidity. Little progress has been made in the postnatal surgical management of the child with spina bifida. Postnatal surgery is aimed at covering the exposed spinal cord, preventing infection, and treating hydrocephalus with a ventricular shunt. In utero repair of open spina bifida is now performed in selected patients and presents an additional therapeutic alternative for expectant mothers carrying a fetus with MMC. Early fetal intervention may improve neurologic outcome and reduce the hindbrain herniation associated with the Arnold-Chiari II malformation. These changes may improve long-term neurologic function and limit requirements for shunt placements and other surgical interventions. Further research is needed to better understand the pathophysiology of MMC, the ideal timing and technique of repair, and the long-term impact of in utero intervention. A prospective, randomized clinical trial is planned comparing prenatal MMC repair with postnatal repair.
Authors:
N Scott Adzick; Danielle S Walsh
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in pediatric surgery     Volume:  12     ISSN:  1055-8586     ISO Abbreviation:  Semin. Pediatr. Surg.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-09-08     Completed Date:  2004-01-05     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9216162     Medline TA:  Semin Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  168-74     Citation Subset:  IM    
Affiliation:
The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Female
Fetal Diseases / diagnosis*,  surgery*
Fetus / surgery*
Humans
Meningomyelocele / diagnosis*,  surgery*
Pregnancy
Prenatal Diagnosis*

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