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Chapter 46 - Midgestational Fetal Procedures

Prenatal Repair of an Open Neural Tube Defect

Published online by Cambridge University Press:  30 November 2019

Adam C. Adler
Affiliation:
Texas Children's Hospital
Arvind Chandrakantan
Affiliation:
Texas Children's Hospital
Ronald S. Litman
Affiliation:
The Children's Hospital of Philadelphia
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Summary

This chapter, provides an overview for midgestational approach to neural tube defects. The authors describe pathophysiology and associated anomalies related to neural tube defects. The surgical approaches and related anesthetic implications are discussed.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2019

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References

Suggested Reading

Adzick, NS, Thom, EA, Spong, CY, et al. A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med. 2011 Mar 17;364(11):9931004. PMID: 21306277.CrossRefGoogle ScholarPubMed
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(4):734–43. PMID: 28277363.CrossRefGoogle ScholarPubMed
Blumenfeld, YJ, Belfort, MA. Updates in fetal spina bifida repair. Curr Opin Obstet Gynecol. 2018;30(2):123–9. PMID: 29489502.CrossRefGoogle ScholarPubMed
Boat, A, Mahmoud, M, Michelfelder, EC, et al. Supplementing desflurane with intravenous anesthesia reduces fetal cardiac dysfunction during open fetal surgery. Paediatr Anaesth. 2010 Aug;20(8):748–56. PMID: 20670239.CrossRefGoogle ScholarPubMed
Copp, AJ, Stanier, P, Greene, ND. Neural tube defects: recent advances, unsolved questions, and controversies. Lancet Neurol. 2013;12(8):799810. PMID: 23790957.CrossRefGoogle ScholarPubMed
Januschek, E, Röhrig, A, Kunze, S, et al. Myelomeningocele: a single institute analysis of the years 2007 to 2015. Childs Nerv Syst. 2016 Jul;32(7):1281–7. PMID: 27086130.CrossRefGoogle ScholarPubMed
Joyeux, L, Engels, AC, Russo, FM, et al. Fetoscopic versus open repair for spina bifida aperta: a systematic review of outcomes. Fetal Diagn Ther. 2016;39(3):161–71. PMID: 26901156.CrossRefGoogle ScholarPubMed
Moldenhauer, JS, Adzick, NS. Fetal surgery for myelomeningocele: after the Management of Myelomeningocele Study (MOMS). Semin Fetal Neonatal Med. 2017;22(6):360–6. PMID: 29031539.CrossRefGoogle ScholarPubMed
Ngamprasertwong, P, Michelfelder, EC, Arbabi, S, et al. Anesthetic techniques for fetal surgery: effects of maternal anesthesia on intraoperative fetal outcomes in a sheep model. Anesthesiology. 2013;118(4):796808. PMID: 23343650.CrossRefGoogle Scholar

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