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. 2025 Apr:279:114472.
doi: 10.1016/j.jpeds.2025.114472. Epub 2025 Jan 17.

Neurodevelopmental Outcomes after Fetoscopic Myelomeningocele Repair

Romain Corroenne  1 , Sabrina Rangwani  1 , William E Whitehead  2 , Rebecca M Johnson  1 , Ahmed A Nassr  1 , Cara Buskmiller  1 , Jessian L Munoz  1 , Jonathan Castillo  3 , Heidi Castillo  3 , Roopali V Donepudi  1 , Michael A Belfort  1 , Magdalena Sanz Cortes  4
Affiliations

Neurodevelopmental Outcomes after Fetoscopic Myelomeningocele Repair

Romain Corroenne et al. J Pediatr. 2025 Apr.

Abstract

Objectives: To report the neurodevelopmental outcomes after a fetoscopic myelomeningocele repair and to compare them with children who had an open hysterotomy repair or a postnatal repair.

Study design: We included 132 infants (prenatal repair, 93 [69 fetoscopic and 24 open hysterotomy]; postnatal repair, 39). Neurodevelopmental outcomes at or beyond 18 months were evaluated by a developmental pediatrician using the Capute scales (Clinical Adaptive Test [CAT]/Clinical Linguistic & Auditory Milestone Scale [CLAMS]) and/or during parental interview using Developmental Profile 3 test. Scores were examined against reference values at each gestational age. A normal score was defined as ≥70%. Neurodevelopmental scores were compared while adjusting for infants' age at the time of testing and the need for hydrocephalus treatment.

Results: After a fetoscopic repair, normal CLAMS results were observed in 25 of 33 cases (75.8%) and normal CAT in 23 of 33 (69.7%); the Developmental Profile 3 showed normal social-emotional scores in 60 of 65 (92.3%), normal cognition in 55 of 65 (84.6%), normal communication in 51 of 65 (78.5%), normal adaptive behavior in 48 of 65 (73.8%), normal general development in 39 of 65(60%), and normal physical score in 31 of 65 (47.7%) of the cases. Children who underwent a fetoscopic repair had similar neurodevelopmental outcomes compared with those who had an open fetal surgery repair. There was a significantly higher proportion of children with a normal CLAMS (25/33 [75.8%] vs 12/39 [30.8%], P < .01) and normal CAT (23/33 [69.7%] vs 16/39 [41.0%], P = .04) in the fetoscopic group compared with the postnatal repair group.

Conclusions: Children who undergo laparotomy-assisted fetoscopic myelomeningocele repair present with normal neurodevelopmental outcomes in two-thirds of the cases included in this study at ≥ 18 months of age and had similar neurodevelopmental outcomes as those who had an open fetal surgery repair.

Keywords: Capute scales; Spina bifida; developmental profile 3 test; fetal surgery; myelomeningocele; neural tube defect; neurodevelopment.

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Conflict of interest statement

Declaration of Competing Interest The authors declare no conflicts of interest relevant to this article. In addition, the authors have no financial relationships related to this article to disclose. No financial support or grants were received for the work presented in this study.