In:
Fetal Diagnosis and Therapy, S. Karger AG, Vol. 39, No. 3 ( 2016), p. 161-171
Abstract:
〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To compare outcomes of fetoscopic spina bifida aperta repair (FSBAR) with the results of the open approach (OSBAR) as in the Management Of Myelomeningocele Study (MOMS). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This was a systematic comparison of reports on FSBAR with data from the MOMS (n = 78). Inclusion criteria were studies of spina bifida aperta patients who underwent FSBAR and were followed for ≥12 months. Primary outcome was perinatal mortality. Secondary outcomes included operative, maternal, fetal, neonatal and infant outcomes. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Out of 16 reports, we included 5 from 2 centers. Due to bias and heterogeneity, analysis was restricted to two overlapping case series (n = 51 and 71). In those, FSBAR was technically different from OSBAR, had comparable perinatal mortality (7.8 vs. 2.6%, p = 0.212) and shunt rate at 12 months (45 vs. 40%, p = 0.619), longer operation time (223 vs. 105 min, p 〈 0.001), higher preterm prelabor membrane rupture rate (84 vs. 46%, p 〈 0.001), earlier gestational age at birth (32.9 vs. 34.1 weeks, p = 0.03), higher postnatal reoperation rate (28 vs. 2.56%, p 〈 0.001) and absence of uterine thinning or dehiscence (0 vs. 36%, p 〈 0.001). Functional outcomes were not available. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 FSBAR utilizes a different neurosurgical technique, takes longer to complete, induces more prematurity, requires additional postnatal procedures, yet has a comparable shunt rate and is not associated with uterine thinning or dehiscence. Long-term functional data are awaited.
Type of Medium:
Online Resource
ISSN:
1015-3837
,
1421-9964
Language:
English
Publisher:
S. Karger AG
Publication Date:
2016
detail.hit.zdb_id:
1482292-1
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