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Table of Contents
Vol. 37, No. 3, 2015
Issue release date: April 2015
Section title: Original Paper
Fetal Diagn Ther 2015;37:235-240
(DOI:10.1159/000365353)

Fetal Myelomeningocele Repair: The Post-MOMS Experience at the Children's Hospital of Philadelphia

Moldenhauer J.S. · Soni S. · Rintoul N.E. · Spinner S.S. · Khalek N. · Martinez-Poyer J. · Flake A.W. · Hedrick H.L. · Peranteau W.H. · Rendon N. · Koh J. · Howell L.J. · Heuer G.G. · Sutton L.N. · Johnson M.P. · Adzick N.S.
Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, Pa., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: May 21, 2014
Accepted: June 18, 2014
Published online: August 15, 2014
Issue release date: April 2015

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 7

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT

Abstract

Background: Fetal myelomeningocele (fMMC) repair has become accepted as a standard of care option in selected circumstances. We reviewed our outcomes for fMMC repair from referral and evaluation through surgery, delivery and neonatal discharge. Material and Methods: All patients referred for potential fMMC repair were reviewed from January 1, 2011 through March 7, 2014. Maternal and neonatal data were collected on the 100 patients who underwent surgery. Results: 29% of those evaluated met the criteria and underwent fMMC repair (100 cases). The average gestational age was 21.9 weeks at evaluation and 23.4 weeks at fMMC repair. Complications included membrane separation (22.9%), preterm premature rupture of membranes (32.3%) and preterm labor (37.5%). Average gestational age at delivery was 34.3 weeks and 54.2% delivered at ≥35 weeks. The perinatal loss rate was 6.1% (2 intrauterine fetal demises and 4 neonatal demises); 90.8% of women delivered at the Children's Hospital of Philadelphia and 3.4% received transfusions. With regard to the neonates, 2 received ventriculoperitoneal shunts prior to discharge; 71.1% of neonates had no evidence of hindbrain herniation on MRI. Of the 80 neonates evaluated, 55% were assigned a functional level of one or more better than the prenatal anatomic level. Conclusion: In an experienced program, maternal and neonatal outcomes for patients undergoing fMMC repair are comparable to results of the MOMS trial.

© 2014 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: May 21, 2014
Accepted: June 18, 2014
Published online: August 15, 2014
Issue release date: April 2015

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 7

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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