Fetal myelomeningocele repair
case report
DOI:
https://doi.org/10.29327/2457362.65.66-7Keywords:
Fetal surgery, Intrauterine surgery, Meningocele surgeryAbstract
Neural tube defects are common in fetal life, particularly those involving neural tube closure, and are often associated with deficiencies in essential nutrients, such as folic acid and vitamin B12. Among the main malformations, myelomeningocele stands out as the most severe form of spina bifida. The purpose of this article is to report the surgical treatment of a 26-week pregnant patient with a fetus diagnosed with myelomeningocele, who was monitored in the malformed fetus outpatient clinic and underwent correction via laparotomy. The surgery was successful, and the newborn was in good general condition without neurological injuries. Early diagnosis should be made during prenatal care, as early correction in the second trimester of pregnancy can be effective in reducing possible motor sequelae. The treatment approaches are laparotomy, the traditional method, and fetoscopy, a newer and less invasive technique.
References
Practice bulletin no. 187: neural tube defects. Obstet Gynecol [Internet]. 2017 Dec [Cited 2024 Nov 18];130(6):1394-6. Available from: https://journals.lww.com/greenjournal/abstract/2017/12000/practice_bulletin_no__187_summary__neural_tube.39.aspx doi: 10.1097/AOG.0000000000002410
Toriello HV; Policy and Practice Guideline Committee of the American College of Medical Genetics. Policy statement on folic acid and neural tube defects. Genet Med [Internet]. 2011 Jun [Cited 2024 Nov 18];13(6):593-6. Available from: https://www.gimjournal.org/article/S1098-3600(21)04810-3/fulltext doi: 10.1097/GIM.0b013e31821d4188
Greene ND, Copp AJ. Neural tube defects. Annu Rev Neurosci [Internet]. 2014 [Cited 2024 Nov 14];37:221-42. Available from: https://www.annualreviews.org/content/journals/10.1146/annurev-neuro-062012-170354 doi: 10.1146/annurev-neuro-062012-170354
Kancherla V. Neural tube defects: a review of global prevalence, causes, and primary prevention. Childs Nerv Syst [Internet]. 2023 Jul [Cited 2024 Nov 18];39(7):1703-10. Available from: https://link.springer.com/article/10.1007/s00381-023-05910-7 doi: 10.1007/s00381-023-05910-7
Yin J, Wang Y, Wang S, Li G, Gu H, Chen L. Research progress on ultrasound and molecular markers for prenatal diagnosis of neural tube defects. Heliyon [Internet]. 2024 Aug 30 [Cited 2024 Nov 18];10(16):e36060. Available from: https://www.cell.com/heliyon/fulltext/S2405-8440(24)12091-9 doi: 10.1016/j.heliyon.2024.e36060
U.S. Preventive Services Task Force. Folic acid for the prevention of neural tube defects: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med [Internet]. 2009 May 5 [Cited 2024 Nov 18];150(9):626-31. Available from: https://www.acpjournals.org/doi/10.7326/0003-4819-150-9-200905050-00009 doi: 10.7326/0003-4819-150-9-200905050-00009
Heuer GG, Moldenhauer JS, Scott Adzick N. Prenatal surgery for myelomeningocele: review of the literature and future directions. Childs Nerv Syst [Internet]. 2017 Jul [Cited 2024 Nov 18];33(7):1149-55. Available from: https://link.springer.com/article/10.1007/s00381-017-3440-z doi: 10.1007/s00381-017-3440-z
Church PT, Castillo H, Castillo J, Berndl A, Brei T, Heuer G, Howell LJ, Merkens M. Prenatal counseling: guidelines for the care of people with spina bifida. J Pediatr Rehabil Med [Internet]. 2020 [Cited 2024 Nov 18];13(4):461-6. Available from: https://journals.sagepub.com/doi/full/10.3233/PRM-200735 doi: 10.3233/PRM-200735
Moldenhauer JS, Flake AW. Open fetal surgery for neural tube defects. Best Pract Res Clin Obstet Gynaecol [Internet]. 2019 Jul [Cited 2024 Nov 18];58:121-32. Available from: https://www.sciencedirect.com/science/article/abs/pii/S1521693419300227 doi: 10.1016/j.bpobgyn.2019.03.004
Chmait RH, Monson MA, Pham HQ, Chu JK, Van Speybroeck A, Chon AH, Kontopoulos EV, Quintero RA. Percutaneous/mini-laparotomy fetoscopic repair of open spina bifida: a novel surgical technique. Am J Obstet Gynecol [Internet]. 2022 Sep [Cited 2024 Nov 18];227(3):375-83. Available from: https://www.ajog.org/article/S0002-9378(22)00376-3/abstract doi: 10.1016/j.ajog.2022.05.032
Downloads
Published
Versions
- 2024-11-26 (3)
- 2024-11-21 (2)
- 2024-11-14 (1)
Issue
Section
License
Copyright (c) 2024 Goiana Journal of Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.
