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Randomized Controlled Trial
. 2020;47(12):865-872.
doi: 10.1159/000509245. Epub 2020 Aug 31.

The Management of Myelomeningocele Study: Short-Term Neonatal Outcomes

Natalie E Rintoul  1 , Roberta L Keller  2 , William F Walsh  3 , Pamela K Burrows  4 , Elizabeth A Thom  4 , Michael J Kallan  5 , Lori J Howell  6 , N Scott Adzick  6 ; MOMS Investigators
Affiliations
Randomized Controlled Trial

The Management of Myelomeningocele Study: Short-Term Neonatal Outcomes

Natalie E Rintoul et al. Fetal Diagn Ther. 2020.

Abstract

Introduction: The Management of Myelomeningocele Study was a multicenter randomized trial to compare prenatal and standard postnatal repair of myelomeningocele (MMC). Neonatal outcome data for 158 of the 183 randomized women were published in The New England Journal of Medicine in 2011.

Objective: Neonatal outcomes for the complete trial cohort (N = 183) are presented outlining the similarities with the original report and describing the impact of gestational age as a mediator.

Methods: Gestational age, neonatal characteristics at delivery, and outcomes including common complications of prematurity were assessed.

Results: Analysis of the complete cohort confirmed the initial findings that prenatal surgery was associated with an increased risk for earlier gestational age at birth. Delivery occurred before 30 weeks of gestation in 11% of neonates that had fetal MMC repair. Adverse pulmonary sequelae were rare in the prenatal surgery group despite an increased rate of oligohydramnios. There was no significant difference in other complications of prematurity including patent ductus arteriosus, sepsis, necrotizing enterocolitis, periventricular leukomalacia, and intraventricular hemorrhage.

Conclusion: The benefits of prenatal surgery outweigh the complications of prematurity.

Keywords: Myelomeningocele; Neonatal outcome; Prenatal surgery; Preterm delivery.

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Conflict of interest statement

The authors have no conflicts of interest and no financial relationships relevant to this article to disclose.

References

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