Use of bipedicular advancement flaps for intrauterine closure of myeloschisis.

Several groups have begun to explore the feasibility and utility of intrauterine closure of myelomeningocele. A subset of these fetuses have defects which fall into the category of myeloschisis, and therefore have inadequate skin to enable primary closure. After considerable discussion, it was decided to utilize bipedicular flaps to close these lesions. The procedure is described, and representative examples are shown. To date, 13 of 56 fetuses have required this approach for closure in utero. While this technique generally provides adequate coverage of the dural sac, the cosmetic results have been less than optimal. Copyright 2000 S. Karger AG, Basel