Intrauterine myelomeningocele repair Postnatal results and follow-up at 3.5 years of age - initial experience from a single reference service in Brazil

Intrauterine myelomeningocele repair Postnatal results and follow-up at 3.5 years of age - initial experience from a single reference service in Brazil

Author Hisaba, Wagner Jou Autor UNIFESP Google Scholar
Cavalheiro, Sergio Autor UNIFESP Google Scholar
Almodim, Carlos Gilberto Autor UNIFESP Google Scholar
Borges, Carolina Peixoto Autor UNIFESP Google Scholar
Carbonari de Faria, Tereza Cristina Autor UNIFESP Google Scholar
Araujo Junior, Edward Autor UNIFESP Google Scholar
Machado Nardozza, Luciano Marcondes Autor UNIFESP Google Scholar
Moron, Antonio Fernandes Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Present the outcomes of six cases submitted to intrauterine myelomeningocele (MMC) repair.Descriptive observational study of six children submitted to antenatal surgical repair of MMC between 26 and 27 weeks gestation. All deliveries were through cesarean section. the following neonatal variables were assessed: gestational age at delivery, birth weight, Apgar scores, need for intubation, duration of hospital stay and need for postnatal shunt procedures. After 3.5 years, the children were evaluated using the Columbia Mental Maturity Scale or Denver II tests and the Hoffer Ambulation Scale.All deliveries were preterm at a mean gestational age of 32 + 4 weeks and mean birth weight was 1,942 g. Two infants had Apgar scores < 7 at 1 min and 1 at 5 min. Ventricular-peritoneal shunts were placed in two cases. All six children are alive: five have normal cognitive development and one has a neuropsychomotor developmental delay. Two children had normal leg movements, a sacral functional level and are community ambulators. Three children had upper lumbar anatomical level lesions and one had a lower thoracic level lesion at the time of fetal surgery. One child, with an L1-L2 anatomical level lesion, in noambulatory and fully dependent on a wheelchair for mobility.Antenatal surgical repair of MMC reduced the need for postnatal shunt placements. Despite preterm delivery, the cognitive development of most children at 3.5 years was normal. Antenatal surgery seemed to improve lower limb motor function in these cases.
Keywords Myelomeningocele
Intrauterine surgery
Postnatal results
Cognitive results
Motor results
Language English
Date 2012-03-01
Published in Childs Nervous System. New York: Springer, v. 28, n. 3, p. 461-467, 2012.
ISSN 0256-7040 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 461-467
Origin http://dx.doi.org/10.1007/s00381-011-1662-z
Access rights Closed access
Type Article
Web of Science ID WOS:000300663300021
URI http://repositorio.unifesp.br/handle/11600/34661

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