Abstract:
:Myelomeningocele (MMC) is a common birth defect that is associated with significant lifelong morbidity. Little progress has been made in the postnatal surgical management of the child with spina bifida. Postnatal surgery is aimed at covering the exposed spinal cord, preventing infection, and treating hydrocephalus with a ventricular shunt. In utero repair of open spina bifida is now performed in selected patients and presents an additional therapeutic alternative for expectant mothers carrying a fetus with MMC. Early fetal intervention may improve neurologic outcome and reduce the hindbrain herniation associated with the Arnold-Chiari II malformation. These changes may improve long-term neurologic function and limit requirements for shunt placements and other surgical interventions. Further research is needed to better understand the pathophysiology of MMC, the ideal timing and technique of repair, and the long-term impact of in utero intervention. A prospective, randomized clinical trial is planned comparing prenatal MMC repair with postnatal repair.
journal_name
Semin Pediatr Surgjournal_title
Seminars in pediatric surgeryauthors
Adzick NS,Walsh DSdoi
10.1016/s1055-8586(03)00029-5keywords:
subject
Has Abstractpub_date
2003-08-01 00:00:00pages
168-74issue
3eissn
1055-8586issn
1532-9453pii
S1055858603000295journal_volume
12pub_type
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journal_title:Seminars in pediatric surgery
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