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Case Reports
. 2015 Oct;126(4):881-884.
doi: 10.1097/AOG.0000000000000835.

Fetoscopic Repair of Meningomyelocele

Michael A Belfort  1 , William E Whitehead, Alireza A Shamshirsaz, Rodrigo Ruano, Darrell L Cass, Oluyinka O Olutoye
Affiliations
Case Reports

Fetoscopic Repair of Meningomyelocele

Michael A Belfort et al. Obstet Gynecol. 2015 Oct.

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.

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Comment in

  • Fetoscopic Repair of Meningomyelocele.
    Moise KJ Jr, Tsao K, Papanna RM, Bebbington MW. Moise KJ Jr, et al. Obstet Gynecol. 2015 Sep;126(3):674. doi: 10.1097/AOG.0000000000001020. Obstet Gynecol. 2015. PMID: 26287774 No abstract available.
  • In Reply.
    Belfort M, Whitehead W, Shamshirsaz A, Ruano R, Cass D, Olutoye O. Belfort M, et al. Obstet Gynecol. 2015 Sep;126(3):674-675. doi: 10.1097/AOG.0000000000001021. Obstet Gynecol. 2015. PMID: 26509198 No abstract available.

References

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    1. Zamora IJ, Ethun CG, Evans LM, Olutoye OO, Ivey RT, Haeri S, et al.. Maternal morbidity and reproductive outcomes related to fetal surgery. J Pediatr Surg 2013;48:951–5.
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    1. Bruner JP, Tulipan NB, Richards WO. Endoscopic coverage of fetal myelomeningocele in-utero. Am J Obstet Gynecol 1997;176:256–7.
    1. Bruner JP, Richards WO, Tulipan NB, Arney TL. Endoscopic coverage of fetal myelomeningocele in utero. Am J Obstet Gynecol 1999;180:153–8.

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