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Review
. 2021 Jun;119(3):e215-e228.
doi: 10.5546/aap.2021.eng.e215.

Update on prenatal diagnosis and fetal surgery for myelomeningocele

[Article in English, Spanish]
César Meller  1 , Delfina Covini  2 , Horacio Aiello  3 , Gustavo Izbizky  3 , Santiago Portillo Medina  4 , Lucas Otaño  3
Affiliations
Free article
Review

Update on prenatal diagnosis and fetal surgery for myelomeningocele

[Article in English, Spanish]
César Meller et al. Arch Argent Pediatr. 2021 Jun.
Free article

Abstract
in English, Spanish

A seminal study titled Management of Myelomeningocele Study, from 2011, demonstrated that prenatal myelomeningocele defect repaired before 26 weeks of gestation improved neurological outcomes; based on this study, fetal surgery was introduced as a standard of care alternative. Thus, prenatal myelomeningocele diagnosis within the therapeutic window became a mandatory goal; therefore, research efforts on screening strategies were intensified, especially in the first trimester. In addition, different fetal surgery techniques were developed to improve neurological outcomes and reduce maternal risks. The objective of this review is to provide an update on the advances in prenatal screening and diagnosis during the first and second trimesters, and in open and fetoscopic fetal surgery for myelomeningocele.

A partir del estudio seminal Management of Myelomeningocele Study en el año 2011, el cual demostró que la reparación prenatal del defecto del mielomeningocele antes de la semana 26 mejoraba los resultados neurológicos, la cirugía fetal fue incorporada dentro de las opciones de estándar de cuidado. Así, el diagnóstico prenatal del mielomeningocele dentro de la ventana terapéutica se convirtió en un objetivo obligatorio y, por ello, se intensificó la investigación de estrategias de tamizaje, sobre todo, en el primer trimestre. Además, se desarrollaron distintas técnicas de cirugía fetal para mejorar los resultados neurológicos y disminuir los riesgos maternos. El objetivo de la siguiente revisión es actualizar los avances en tamizaje y diagnóstico prenatal en el primer y segundo trimestre, y en cirugía fetal abierta y fetoscópica del mielomeningocele.

Keywords: antenatal care; fetal therapies; fetoscopy; myelomeningocele; spina bifida.

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Conflict of interest statement

None

References

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