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Open fetal surgery for myelomeningocele — is there the learning curve at reduction mother and fetal morbidity?
, 1, 1, 1, 2, 1, 3, 2, 1
Affiliations- Medical University of Silesia, Gynecology Clinical Care Unit, Obstetrics and Oncological Gynecology, Bytom, Poland
- Medical University of Silesia, School of Medicine in Katowice, Department of Pediatric Surgery and Urology, Katowice, Poland
- Collegium Medicum, Jagiellonian University, Department of Electroradiology, Cracow, Poland
open access
Abstract
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.
Abstract
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.
Keywords
myelomeningocele; fetal surgery; spina bifida; Chiari malformation
About this articleTitle
Open fetal surgery for myelomeningocele — is there the learning curve at reduction mother and fetal morbidity?
Journal
Issue
Article type
Research paper
Pages
123-131
Published online
2020-03-31
Page views
1181
Article views/downloads
1075
DOI
Pubmed
Bibliographic record
Ginekol Pol 2020;91(3):123-131.
Keywords
myelomeningocele
fetal surgery
spina bifida
Chiari malformation
Authors
Ewa I. Horzelska
Mateusz Zamlynski
Tomasz Horzelski
Jacek Zamlynski
Agnieszka Pastuszka
Rafal Bablok
Izabela Herman-Sucharska
Tomasz Koszutski
Anita Olejek
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