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Chapter 10 - Myelomeningocele Repair

from Section 3

Published online by Cambridge University Press:  19 November 2021

Olutoyin A. Olutoye
Affiliation:
Ann & Robert H. Lurie Children's Hospital of Chicago, Illinois
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Summary

Prenatal myelomeningocele has rapidly become the most common in-utero surgery performed following the results of the multi-center, myelomeningocele study. In-utero surgery has greatly improved the prognosis of babies with spina bifida or myelomeningocele. The eligibility criteria for this surgery has also evolved as some centers are now operating on mothers with increased body mass index (BMI). A BMI greater than 40 was not incorporated into the original study. In addition, fetoscopic repair of the myelomeningocele is also being performed, allowing for a decrease in the risk for uterine dehiscence and also offering mothers the opportunity to have a vaginal delivery following in-utero surgery.

Type
Chapter
Information
Anesthesia for Maternal-Fetal Surgery
Concepts and Clinical Practice
, pp. 137 - 151
Publisher: Cambridge University Press
Print publication year: 2021

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References

McLone, DG, Knepper, PA. The cause of Chiari II malformation: a unified theory. Pediatr Neurosc. 1989;15:112.Google Scholar
Heffez, DS, Aryanpur, J, Hutchins, GM, Freeman, JM. The paralysis associated with myelomeningocele: clinical and experimental data implicating a preventable spinal cord injury. Neurosurgery. 1990;26:987992.Google Scholar
Meuli, M, Meuli-Simmen, C, Hutchins, GM, et al. In utero surgery rescues neurological function at birth in sheep with spina bifida. Nat Med. 1995;1:342347.Google Scholar
Meuli, M, Meuli-Simmen, C, Yingling, CD, et al. Creation of myelomeningocele in utero: a model of functional damage from spinal cord exposure in fetal sheep. J Pediatr Surg. 1995;30:1028–32; discussion 32–3.CrossRefGoogle Scholar
Michejda, M. Intrauterine treatment of spina bifida: primate model. Z Kinderchir. 1984;39:259261.Google ScholarPubMed
Bruner, JP, Tulipan, NE, Richards, WO. Endoscopic coverage of fetal open myelomeningocele in utero. Am J Obstet Gynecol. 1997;176:256257.Google Scholar
Farmer, DL, von Koch, CS, Peacock, WJ, et al. In utero repair of myelomeningocele: experimental pathophysiology, initial clinical experience, and outcomes. Arch Surg. 2003;138:872878.CrossRefGoogle ScholarPubMed
Blencowe, H, Cousens, S, Modell, B, Lawn, J. Folic acid to reduce neonatal mortality from neural tube disorders. Int J Epidemiol. 2010;39 Suppl1: i110121.Google Scholar
Maroto, A, Illescas, T, Melendez, M, et al. Ultrasound functional evaluation of fetuses with myelomeningocele: study of the interpretation of results. J Matern Fetal Neonatal Med. 2017;30:23012305.Google Scholar
Midrio, P, Silberstein, HJ, Bilaniuk, LT, Adzick, NS, Sutton, LN. Prenatal diagnosis of terminal myelocystocele in the fetal surgery era: case report. Neurosurgery. 2002;50:11521154; discussion 4–5.Google Scholar
Heffez, DS, Aryanpur, J, Rotellini, NA, et al. Intrauterine repair of experimental surgically created dysraphism. Neurosurgery. 1993;32:10051010.CrossRefGoogle ScholarPubMed
Ueber, HC. Veränderungen des Kleinhirns infolge von Hydrocephalie des Grosshirns. Deutsche Medicinische Wochenschrift. 1891;17:11721175.Google Scholar
Stevenson, KL. Chiari Type II malformation: past, present, and future. Neurosurg Focus. 2004;16:E5.Google Scholar
Tulipan, N, Wellons, JC, 3rd, Thom, EA, et al. Prenatal surgery for myelomeningocele and the need for cerebrospinal fluid shunt placement. J Neurosurg Pediatr. 2015;16:613620.CrossRefGoogle ScholarPubMed
McComb, JG, Mittler, M. Myelomeningoceles and meningoceles. In: Albright, AL, Pollack, IF, Adelson, PD, eds. Operative Techniques in Pediatric Neurosurgery. New York: Thieme; 2001:7588.Google Scholar
Heuer, GG, Adzick, NS, Sutton, LN. Fetal myelomeningocele closure: technical considerations. Fetal Diagn Ther. 2015;37:166171.Google Scholar
Kohl, T. Percutaneous minimally invasive fetoscopic surgery for spina bifida aperta. Part I: surgical technique and perioperative outcome. Ultrasound Obstet Gynecol. 2014;44:515524.Google Scholar
Adzick, NS, Thom, EA, Spong, CY, et al. A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med. 2011;364:9931004.Google Scholar
Cheek, WR, Laurent, JP, Cech, DA. Operative repair of lumbosacral myelomeningocele. Technical note. J Neurosurg. 1983;59:718722.Google ScholarPubMed
Bennett, KA, Carroll, MA, Shannon, CN, et al. Reducing perinatal complications and preterm delivery for patients undergoing in utero closure of fetal myelomeningocele: further modifications to the multidisciplinary surgical technique. J Neurosurg Pediatr. 2014;14:108114.Google Scholar
Meuli, M, Meuli-Simmen, C, Mazzone, L, et al. In utero plastic surgery in Zurich: successful use of distally pedicled random pattern transposition flaps for definitive skin closure during open fetal spina bifida repair. Fetal Diagn Ther. 2018;44:173178.Google Scholar
Belfort, MA, Whitehead, WE, Shamshirsaz, AA, et al. Fetoscopic repair of meningomyelocele. Obstet Gynecol. 2015;126:881884.CrossRefGoogle ScholarPubMed
Kabagambe, SK, Jensen, GW, Chen, YJ, et al. Fetal surgery for myelomeningocele: a systematic review and meta-analysis of outcomes in fetoscopic versus open repair. Fetal Diagn Ther. 2018;43:161174CrossRefGoogle ScholarPubMed
Ferschl, M, Ball, R, Lee, H, Rollins, MD. Anesthesia for in utero repair of myelomeningocele. Anesthesiology. 2013;118:12111223.Google Scholar
Grivell, R, Andersen, C, Dodd, J. Prenatal versus postnatal repair procedures for spina bifida for improving infant and maternal outcomes. Cochrane Database Syst Rev. 2014;10:CD008825.Google Scholar
Van de Velde, M, De Buck, F. Fetal and maternal analgesia/anesthesia for fetal procedures. Fetal Diagn Ther. 2012;31:201209.CrossRefGoogle ScholarPubMed
Committee Opinion No. 720: Maternal–Fetal Surgery for Myelomeningocele. Obstet Gynecol. 2017;130:e164167.CrossRefGoogle Scholar
Hoagland, MA, Chatterjee, D. Anesthesia for fetal surgery. Pediatr Anesth. 2017;27:346357.Google Scholar
Belfort, MA, Whitehead, WE, Shamshirsaz, AA, et al. Fetoscopic open neural tube defect repair: development and refinement of a two-port, carbon dioxide insufflation technique. Obstet Gynecol. 2017;129:734743.Google Scholar

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