BACKGROUND: Currently, maternal-fetal surgery for repair of myelomeningocele requires an upper-segment hysterotomy, which likely increases maternal postsurgical risks. If fetoscopic repair of myelomeningocele achieves similar or better fetal outcomes while decreasing maternal risks, it would be a better option. CASE: A patient with a fetus with a L3-S1 meningomyelocele underwent a laparotomy and fetoscopic repair using a two-port, in-CO2 approach at 23 2/7 weeks of gestation. The neonate was delivered at 30 6/7 weeks of gestation by lower segment cesarean delivery and required no further surgery, has not needed a shunt (5 months), and has normal, age-appropriate neurologic function. CONCLUSION: This innovative fetoscopic approach may offer an alternative to open fetal surgery and may prevent the need for hysterotomy and cesarean delivery in index and subsequent pregnancies.
BACKGROUND: Currently, maternal-fetal surgery for repair of myelomeningocele requires an upper-segment hysterotomy, which likely increases maternal postsurgical risks. If fetoscopic repair of myelomeningocele achieves similar or better fetal outcomes while decreasing maternal risks, it would be a better option. CASE: A patient with a fetus with a L3-S1 meningomyelocele underwent a laparotomy and fetoscopic repair using a two-port, in-CO2 approach at 23 2/7 weeks of gestation. The neonate was delivered at 30 6/7 weeks of gestation by lower segment cesarean delivery and required no further surgery, has not needed a shunt (5 months), and has normal, age-appropriate neurologic function. CONCLUSION: This innovative fetoscopic approach may offer an alternative to open fetal surgery and may prevent the need for hysterotomy and cesarean delivery in index and subsequent pregnancies.
Authors: Sandra K Kabagambe; Y Julia Chen; Melissa A Vanover; Payam Saadai; Diana L Farmer Journal: Childs Nerv Syst Date: 2017-05-11 Impact factor: 1.475
Authors: Kavita Narang; Amro Elrefaei; Michelle A Wyatt; Lindsay L Warner; Ayssa Teles Abrao Trad; Leal G Segura; Ellen Bendel-Stenzel; Edward S Ahn; Katherine W Arendt; M Yasir Qureshi; Rodrigo Ruano Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2020-08-19
Authors: Adolfo Etchegaray; Fernando Palma; Roberto De Rosa; Ricardo Daniel Russo; Ernesto Beruti; Rodolfo Fregonese; Hernán Allegrotti; Gabriel Musante; Angeles Cibert; Florencia Contino Storz; Sofia Marchionatti Journal: Surg Neurol Int Date: 2018-11-26