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Obstet Gynecol. 2015 Oct;126(4):881-4. doi: 10.1097/AOG.0000000000000835.

Fetoscopic Repair of Meningomyelocele.

Author information

1
Baylor College of Medicine, Departments of Obstetrics and Gynecology, Neurosurgery, and Surgery, Texas Children's Fetal Center, Texas Children's Hospital, Houston, Texas.

Abstract

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.

Comment in

PMID:
25923030
DOI:
10.1097/AOG.0000000000000835
[Indexed for MEDLINE]

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