Vol 91, No 3 (2020)
Research paper
Published online: 2020-03-31

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Open fetal surgery for myelomeningocele — is there the learning curve at reduction mother and fetal morbidity?

Ewa I. Horzelska1, Mateusz Zamlynski1, Tomasz Horzelski1, Jacek Zamlynski1, Agnieszka Pastuszka2, Rafal Bablok1, Izabela Herman-Sucharska3, Tomasz Koszutski2, Anita Olejek1
Pubmed: 32266952
Ginekol Pol 2020;91(3):123-131.


Objectives: We aimed to show how increased experience of a surgery team in fMMC repair influences maternal and
fetal/neonatal outcomes.
Material and methods: We compare perinatal results of fMMC repair in our Fetal Surgery Center (FSC) in cohort groups for
the early period (2005–2011 year; previous — PFSC, n = 46) and current period (2012–2015 year; current — CFSC, n = 74)
to results of the randomized Management of Myelomeningocele Study (MOMS, 78 patients).
Results: The maternal morbidity due to fMMC repair was low and there was no difference comparing CFSC to PFSC and
MOMS. The frequency of iatrogenic preterm labor (iPTL) ≤ 30 weeks of gestation decreased from 34.1% in PFSC to 23.9%
in CFSC. Iatrogenic preterm premature rupture of membranes (iPPROM) was a common complication after fMMC repair in
all cohorts. The total reduction rate of hindbrain hernation (HH) was similar in CFSC — 90.3% and PFSC — 82.1%.
Conclusions: The increasing experience of our surgery team in fMMC repair majorly decreased the risk of iPTL.

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