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Myelomeningocele

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1. Maternal?Fetal Surgery for Myelomeningocele

Maternal?Fetal Surgery for Myelomeningocele Maternal–Fetal Surgery for Myelomeningocele - ACOG Menu ▼ Maternal–Fetal Surgery for Myelomeningocele Page Navigation ▼ Number 720, September 2017 (Replaces Committee Opinion Number 550, January 2013) Committee on Obstetric Practice Society for Maternal–Fetal Medicine The North American Fetal Therapy Network endorses this document. This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Obstetric (...) direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented. Maternal–Fetal Surgery for Myelomeningocele ABSTRACT: Myelomeningocele, a severe form of spina bifida, occurs in approximately 1 in 3,000 live births in the United States. The extent of disability is generally related to the level of the myelomeningocele defect, with a higher upper level of lesion generally corresponding to greater deficits. Open maternal–fetal

2017 American College of Obstetricians and Gynecologists

2. Cerebellar herniation demonstrated by the occipitum-dens line: ultrasonography assessment of normal fetuses, fetuses with myelomeningocele, and fetuses that underwent antenatal myelomeningocele surgery. (PubMed)

Cerebellar herniation demonstrated by the occipitum-dens line: ultrasonography assessment of normal fetuses, fetuses with myelomeningocele, and fetuses that underwent antenatal myelomeningocele surgery. To establish a method to quantify the position of the cerebellum by ultrasonography in normal fetuses, fetuses with myelomeningocele (MMC), and fetuses that underwent in utero MMC repair.Reference points identifiable on ultrasound were established. The basilar portion of the occipital bone

2018 Prenatal diagnosis

3. Fetal surgery for myelomeningocele: After the Management of Myelomeningocele Study (MOMS). (PubMed)

Fetal surgery for myelomeningocele: After the Management of Myelomeningocele Study (MOMS). Myelomeningocele (MMC) is the most frequently occurring congenital abnormality of the central nervous system and leads to significant physical disabilities. Historically treatment involved postnatal closure with management of the associated sequelae including ventricular shunting. The mechanism of neurologic damage that begins with abnormal neurulation followed by continued injury over the course (...) of gestation made MMC a plausible candidate for in-utero surgical repair. Animal and early human studies demonstrated the feasibility of fetal closure. The benefit of in-utero closure was debated until the results of the prospective randomized multicenter Management of Myelomeningocele Study (MOMS trial) were published, demonstrating a decreased need for shunting, reversal of hindbrain herniation, and better neurologic function in the prenatal repair group compared to postnatal repair with maternal

2017 Seminars in fetal & neonatal medicine

4. The Management of Myelomeningocele Study: full cohort 30-month pediatric outcomes

The Management of Myelomeningocele Study: full cohort 30-month pediatric outcomes Previous reports from the Management of Myelomeningocele Study demonstrated that prenatal repair of myelomeningocele reduces hindbrain herniation and the need for cerebrospinal fluid shunting, and improves motor function in children with myelomeningocele. The trial was stopped for efficacy after 183 patients were randomized, but 30-month outcomes were only available at the time of initial publication in 134 mother (...) -child dyads. Data from the complete cohort for the 30-month outcomes are presented here. Maternal and 12-month neurodevelopmental outcomes for the full cohort were reported previously.The purpose of this study is to report the 30-month outcomes for the full cohort of patients randomized to either prenatal or postnatal repair of myelomeningocele in the original Management of Myelomeningocele Study.Eligible women were randomly assigned to undergo standard postnatal repair or prenatal repair <26 weeks

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2018 EvidenceUpdates

5. Systematic review of scoliosis treatment among individuals living with myelomeningocele or spina bifida in Asia

Systematic review of scoliosis treatment among individuals living with myelomeningocele or spina bifida in Asia Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files

2019 PROSPERO

6. Heated humidified carbon dioxide for partial uterine insufflation in fetoscopic myelomeningocele repair: insights from animal model. (PubMed)

Heated humidified carbon dioxide for partial uterine insufflation in fetoscopic myelomeningocele repair: insights from animal model. Linked Comment: Ultrasound Obstet Gynecol 2018; 53: 340-347.Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

2019 Ultrasound in Obstetrics and Gynecology

7. Two-Port Fetoscopic Repair of Myelomeningocele in Fetal Lambs. (PubMed)

Two-Port Fetoscopic Repair of Myelomeningocele in Fetal Lambs. The aim of this study was to assess the feasibility and the effectiveness of a fetoscopic myelomeningocele (MMC) repair with a running single suture using a 2-port access in the sheep model.Eighteen fetuses underwent surgical creation of a MMC defect at day 75. Fetuses were then randomized into 3 groups. Four fetuses remained untreated (control group). In the other 14 fetuses, a prenatal repair was performed at day 90: 7 fetuses had

2019 Fetal diagnosis and therapy

8. Effect of Prenatal Repair of Myelomeningocele on Urological Outcomes at School Age. (PubMed)

Effect of Prenatal Repair of Myelomeningocele on Urological Outcomes at School Age. To investigate longer-term urological outcomes in patients enrolled in the Management of Myelomeningocele Study (MOMS).Women who participated in the original trial were asked for consent to their child being followed-up at 6 years or older in a single comprehensive study visit to a MOMS center. Participating children underwent urologic and radiologic procedures to provide objective evidence of current bladder (...) volitionally. Augmentation cystoplasty, vesicostomy, and urethral dilation did not differ between the two groups. Aside from a larger post residual urodynamic catheterization volume, there were no other statistical differences in video-urodynamic data or findings on renal/bladder ultrasound.Prenatal closure of myelomeningocele resulted in less reported CIC at school-age. The mechanism for this is unclear. Although most children are in diapers or on CIC, parental reports showed children who underwent

2019 Journal of Urology

9. Heritable Spina Bifida in Sheep: A Potential Model for Fetal Repair of Myelomeningocele. (PubMed)

Heritable Spina Bifida in Sheep: A Potential Model for Fetal Repair of Myelomeningocele. In 2004, a heritable occurrence of spina bifida was reported in sheep on a farm in the United States. We maintained and characterized the spina bifida phenotype in this flock to assess its potential as an alternative surgical model.A breeding strategy was developed in which the sheep were crossed to maintain or increase the occurrence of spina bifida. Measurements and observations were recorded regarding (...) displayed a range of ambulatory and urological deficits which could be used to evaluate new fetal repair methodologies. Finally, affected lambs were shown to demonstrate severe Chiari malformations and hydrocephalus.We have determined that use of these sheep as a natural source for spina bifida fetuses is feasible and could supplement the deficits of current sheep models for myelomeningocele repair.Level IV.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 Journal of Pediatric Surgery

10. Does Kyphectomy Improve the Quality of Life of Patients With Myelomeningocele? (PubMed)

Does Kyphectomy Improve the Quality of Life of Patients With Myelomeningocele? Lumbar kyphosis is a complex spinal deformity occurring in approximately 8% to 20% of patients with myelomeningocele. The resulting gibbosity may cause pressure ulcers, difficulty lying down in the supine position and sitting on the ischia without support, decreasing quality of life (QOL). Surgery is generally performed to correct kyphosis and maintain vertebral alignment, but high complication rates have been (...) reported. Despite satisfactory radiological results, the impact of surgery and its complications on health-related QOL (HRQOL) has not yet been established.Among children with myelomeningocele undergoing corrective surgery for lumbar kyphosis: (1) What is the risk of complications and reoperation after this procedure? (2) Does this procedure improve HRQOL scores in these patients?Between 2012 and 2013, five surgeons at three centers treated 32 patients for myelomeningocele-related kyphosis

2019 Clinical Orthopaedics and Related Research

11. Prenatal folic acid use associated with decreased risk of myelomeningocele: A case-control study offers further support for folic acid fortification in Bangladesh. (PubMed)

Prenatal folic acid use associated with decreased risk of myelomeningocele: A case-control study offers further support for folic acid fortification in Bangladesh. Neural tube defects contribute to severe morbidity and mortality in children and adults; however, they are largely preventable through maternal intake of folic acid before and during early pregnancy. We examined the association between maternal prenatal folic acid supplement intake and risk of myelomeningocele (a severe and common (...) type of neural tube defect) in the offspring. We performed secondary analysis using data from a case-control study conducted at Dhaka Community Hospital, Bangladesh between April and November of 2013. Cases and controls included children with and without myelomeningocele, respectively, and their mothers. Cases were identified from local hospitals and rural health clinics served by Dhaka Community Hospital. Controls were selected from pregnancy registries located in the same region as the cases

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2017 PLoS ONE

12. Clusters of amniotic fluid cells and their associated early neuroepithelial markers in experimental myelomeningocele: Correlation with astrogliosis. (PubMed)

Clusters of amniotic fluid cells and their associated early neuroepithelial markers in experimental myelomeningocele: Correlation with astrogliosis. Myelomeningocele (MMC) is the most common and severe disabling type of spina bifida resulting in the exposure of vulnerable spinal cord to the hostile intrauterine environment. In this study, we sought to examine the cellular content of fetal amniotic fluid (AF) in MMC and explore a correlation between these cells and pathological development

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2017 PLoS ONE

13. Protocol for open spinal dysraphism - myelomeningocele

Protocol for open spinal dysraphism - myelomeningocele Protocol for open spinal dysraphism - myelomeningocele | Great Ormond Street Hospital Google Tag Manager Navigation Search Search You are here Protocol for open spinal dysraphism - myelomeningocele Protocol for open spinal dysraphism - myelomeningocele Policies and legal statements Follow Us Great Ormond Street Hospital Tel: 020 7405 9200 Great Ormond Street Hospital for Children NHS Foundation Trust Great Ormond Street London WC1N 3JH ©

2015 Great Ormond Street Hospital

14. Protocol for open spinal dysraphism - myelomeningocele

Protocol for open spinal dysraphism - myelomeningocele Protocol for open spinal dysraphism - myelomeningocele | Great Ormond Street Hospital Google Tag Manager Navigation Search Search You are here Protocol for open spinal dysraphism - myelomeningocele Protocol for open spinal dysraphism - myelomeningocele Policies and legal statements Follow Us Great Ormond Street Hospital Tel: 020 7405 9200 Great Ormond Street Hospital for Children NHS Foundation Trust Great Ormond Street London WC1N 3JH ©

2015 Great Ormond Street Hospital

15. A Study to Assess Global Availability of Fetal Surgery for Myelomeningocele. (PubMed)

A Study to Assess Global Availability of Fetal Surgery for Myelomeningocele. To establish the provision of fetal surgery for myelomeningocele (MMC) worldwide.Through the International Society for Prenatal Diagnosis (ISPD) Fetal Therapy Special Interest Group and the North American Fetal Therapy Network (NAFTNet), fetal therapy centres were surveyed (September 2017-June 2018) regarding availability of fetal MMC surgical repair, patient inclusion criteria, repair techniques, number of cases (...) , and outcome reporting. Responses were summarised on an interactive map on the ISPD website.Forty-four of 59 centres responded (74.6%) of which 34 centres (77.1%) currently offered fetal surgery for MMC and seven centres (15.9%) were awaiting a first case after service set up. Patient inclusion criteria were similar and based on the Management of Myelomeningocele (MOMS) trial. Five centres (14.7%) operated beyond 26 weeks' gestational age, outside the MOMS criteria. Open fetal surgery was provided in 23

2018 Prenatal diagnosis

16. Children with myelomeningocele do not exhibit normal remodeling of tibia roundness with physical development. (PubMed)

Children with myelomeningocele do not exhibit normal remodeling of tibia roundness with physical development. Skeletal loading through daily movement is an important factor in the normal development of bones. This loading is affected by the neurological and muscle deficits that result from myelominingocele (MM). While children with MM have been shown to have atypical gait, decreased bone accrual, and increased fracture risk, it is still unclear what morphological bone differences exist

2018 Bone

17. Perinatal outcomes after open fetal surgery for myelomeningocele repair: a retrospective cohort study. (PubMed)

Perinatal outcomes after open fetal surgery for myelomeningocele repair: a retrospective cohort study. Describe outcomes of open fetal surgery for myelomeningocele (MMC) repair in two Brazilian hospitals and the impact of surgical experience on outcome.Retrospective cohort study.Sao Paulo, Brazil.237 pregnant women carrying a fetus with an open spinal defect.Surgical details, and maternal and fetal outcomes collected from all patients.Analysis of surgical and perinatal outcome parameters.Total (...) study was funded solely by institutional funds.Brazilian experience of in utero open surgery for myelomeningocele repair.© 2018 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

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2018 BJOG

18. Impact on family and parental stress of prenatal vs postnatal repair of myelomeningocele (PubMed)

Impact on family and parental stress of prenatal vs postnatal repair of myelomeningocele The Management of Myelomeningocele Study was a multicenter, randomized controlled trial that compared prenatal repair with standard postnatal repair for fetal myelomeningocele.We sought to describe the long-term impact on the families of the women who participated and to evaluate how the timing of repair influenced the impact on families and parental stress.Randomized women completed the 24-item Impact

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2016 EvidenceUpdates

19. Myelomeningocele with Unilateral Right Renal Agenesis: A Case Report (PubMed)

Myelomeningocele with Unilateral Right Renal Agenesis: A Case Report Congenital anomalies of the spine may occur with malformations of the central nervous, cardiovascular, gastrointestinal, respiratory, and genitourinary systems. This is a case of myelomeningocele with unilateral right renal agenesis in a newborn. The patient suffered complications of cerebrospinal fluid leak and meningitis, but was successfully treated and discharged on day 86. In this case, unilateral right renal agenesis

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2018 AJP Reports

20. Can Dynamic Ultrasonography Replace Urodynamics in Follow-up of Patients With Myelomeningocele

Can Dynamic Ultrasonography Replace Urodynamics in Follow-up of Patients With Myelomeningocele Can Dynamic Ultrasonography Replace Urodynamics in Follow-up of Patients With Myelomeningocele - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one (...) or more studies before adding more. Can Dynamic Ultrasonography Replace Urodynamics in Follow-up of Patients With Myelomeningocele The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03550898 Recruitment Status : Completed First Posted : June 8, 2018 Last Update Posted : June 8, 2018 Sponsor: Hospital de

2018 Clinical Trials

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