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Myelomeningocele

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81. Prenatal surgery for myelomeningocele and the need for cerebrospinal fluid shunt placement. (PubMed)

Prenatal surgery for myelomeningocele and the need for cerebrospinal fluid shunt placement. The Management of Myelomeningocele Study (MOMS) was a multicenter randomized trial comparing the safety and efficacy of prenatal and postnatal closure of myelomeningocele. The trial was stopped early because of the demonstrated efficacy of prenatal surgery, and outcomes on 158 of 183 pregnancies were reported. Here, the authors update the 1-year outcomes for the complete trial, analyze the primary (...) at initial screening are associated with an increased need for shunting among those undergoing fetal surgery for myelomeningocele. During prenatal counseling, care should be exercised in recommending prenatal surgery when the ventricles are 15 mm or larger because prenatal surgery does not appear to improve outcome in this group. The revised criteria may be useful as guidelines for treating hydrocephalus in this group.

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2015 Journal of neurosurgery. Pediatrics

82. Surgical technique of retrograde ventricle-sinus shunt is an option for the treatment of hydrocephalus in infants after surgical repair of myelomeningocele. (PubMed)

Surgical technique of retrograde ventricle-sinus shunt is an option for the treatment of hydrocephalus in infants after surgical repair of myelomeningocele. Treatment of hydrocephalus is accomplished primarily through a ventricular-peritoneal shunt (VPS). This study aims to describe the application of retrograde ventricle-sinus shunt (RVSS) in patients with hydrocephalus after surgical treatment of myelomeningocele.A prospective, randomized and controlled pilot study. We consecutively enrolled (...) 9 patients with hydrocephalus after surgical repair of myelomeningocele from January 2010 to January 2012. These patients underwent elective RVSS or VPS. Five underwent RVSS and 4 underwent VPS. Patients were followed for one year with quarterly evaluations and application of transcranial Doppler.RVSS group showed outcomes similar to those of VPS group. Doppler revealed significant improvement when comparing preoperative to postoperative period. RVSS group had significantly higher cephalic

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2015 Arquivos de neuro-psiquiatria

83. Chorioamniotic Membrane Separation and Preterm Premature Rupture of Membranes Complicating In Utero Myelomeningocele Repair. (PubMed)

Chorioamniotic Membrane Separation and Preterm Premature Rupture of Membranes Complicating In Utero Myelomeningocele Repair. Since the results of the Management of Myelomeningocele Study were published, maternal-fetal surgery for the in utero treatment of spina bifida has become accepted as a standard of care alternative. Despite promise with fetal management of myelomeningocele repair, there are significant complications to consider. Chorioamniotic membrane separation and preterm premature (...) in a cohort of patients undergoing fetal management of myelomeningocele repair including identification of risk factors and outcomes.This was a retrospective review of patients undergoing fetal management of myelomeningocele repair and subsequent delivery from January 2011 through December 2013 at 1 institution. Patients were identified through the institutional fetal management of myelomeningocele repair database and chart review was performed. Perioperative factors and outcomes among patients

2015 American Journal of Obstetrics and Gynecology

84. Prenatal ultrasound evaluation of the segmental level of neurological lesion in foetuses with myelomeningocele: a new technique developing. (PubMed)

Prenatal ultrasound evaluation of the segmental level of neurological lesion in foetuses with myelomeningocele: a new technique developing. To report our preliminary experience in the use of prenatal ultrasound examination to assess lower-limb movements in fetuses with myelomeningocele. We aimed to determine the accuracy of this method to establish the segmental level of neurological lesion, as this is the best known predictor of the future ability to walk.This was a preliminary, observational (...) study including fetuses with myelomeningocele operated on prenatally. The patterns of movements present and absent in the affected fetuses' lower limbs were evaluated systematically by ultrasound examination. According to the known nerve function associated with each muscle group, the segmental level of neurological lesion was established before birth. The agreement for the segmental levels assigned, between the prenatal ultrasound technique and the classical neurological clinical examination after

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2015 Ultrasound in Obstetrics and Gynecology

85. Fetal Myelomeningocele Repair With Maternal BMI Between 35.0 and 40.0

Fetal Myelomeningocele Repair With Maternal BMI Between 35.0 and 40.0 Fetal Myelomeningocele Repair With Maternal BMI Between 35.0 and 40.0 - 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. Fetal (...) Myelomeningocele Repair With Maternal BMI Between 35.0 and 40.0 (MOMSto40BMI) 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: NCT02509377 Recruitment Status : Terminated First Posted : July 28, 2015 Last Update Posted : June 28, 2018 Sponsor: St. Louis University Information provided by (Responsible Party): St

2015 Clinical Trials

88. A rare case of giant multiseptated thoracic myelomeningocele with segmental placode (PubMed)

A rare case of giant multiseptated thoracic myelomeningocele with segmental placode 26629396 2015 12 02 2018 11 13 2229-5097 6 2015 Surgical neurology international Surg Neurol Int A rare case of giant multiseptated thoracic myelomeningocele with segmental placode. 170 10.4103/2152-7806.169554 Patnaik Ashis A Department of Trauma and Emergency, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India. Mahapatra Ashok Kumar AK Department of Neurosurgery, All India Institute of Medical

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2015 Surgical neurology international

89. Fasting serum blood measures of bone and lipid metabolism in children with myelomeningocele for early detection of cardiovascular and bone fragility risk factors (PubMed)

Fasting serum blood measures of bone and lipid metabolism in children with myelomeningocele for early detection of cardiovascular and bone fragility risk factors This study examined serum levels in children with myelomeningocele to identify the prevalence of pre-clinical signs of disease.A prospective, cross-sectional study.Patients were actively recruited from multidisciplinary care clinics at tertiary children's hospitals from 2010-2012. The control comparison group was recruited by word (...) -of-mouth.Twenty-eight children with myelomeningocele (93% Hispanic; 17 males; 10.0 ± 2.1 years) and 58 controls (84% Hispanic; 30 males; 10.4 ± 2.4 years) provided ≥ 8-hour fasting blood samples with concomitant dual-energy x-ray absorptiometry measurements of body fat.Not applicable.The serum analysis included a lipid panel (cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein), insulin, glucose, leptin, aspartate aminotransferase, alanine transaminase, alkaline phosphatase, albumin

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2015 The journal of spinal cord medicine

90. Attention in spina bifida myelomeningocele: Relations with brain volume and integrity (PubMed)

Attention in spina bifida myelomeningocele: Relations with brain volume and integrity This study investigated the relations of tectal volume and superior parietal cortex, as well as alterations in tectocortical white matter connectivity, with the orienting and executive control attention networks in individuals with spina bifida myelomeningocele (SBM). Probabilistic diffusion tractography and quantification of tectal and superior parietal cortical volume were performed on 74 individuals aged 8

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2015 NeuroImage : Clinical

91. Categorization of bladder dynamics and treatment after fetal myelomeningocele repair: first 50 cases prospectively assessed. (PubMed)

Categorization of bladder dynamics and treatment after fetal myelomeningocele repair: first 50 cases prospectively assessed. We categorized bladder patterns and principles of treatment applied to patients who underwent myelomeningocele repair during gestation in a prospective urological assessment.We performed urinary tract ultrasound, voiding cystourethrogram and urodynamic evaluation. We then categorized patients into 4 patterns, including normal, high risk (overactive bladder with detrusor (...) bladder.Of patients who underwent myelomeningocele closure during gestation 93.7% had significant lower urinary tract dysfunction consisting of high bladder pressure or incontinence. These data reinforce the absolute need to follow these patients closely. The potential benefits of fetal surgery in the urinary tract remain to be proved.Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

2015 Journal of Urology

92. Surgical Treatment of Hip Instability in Patients With Lower Lumbar Level Myelomeningocele: Is Muscle Transfer Required? (PubMed)

Surgical Treatment of Hip Instability in Patients With Lower Lumbar Level Myelomeningocele: Is Muscle Transfer Required? Treatment of hip instability in patients with lower lumbar level myelomeningocele is clinically challenging. Muscle transfer procedures, release of contractures, and intertrochanteric varus-rotation osteotomies have been described to restore weak or absent abductor strength as well as relocation of the hip. However, controlled trials evaluating hip instability in lower lumbar (...) myelomeningocele are limited in the current literature.The purposes of this study were to compare the (1) radiographic evidence for joint stability; (2) clinical outcomes (including abductor strength, ambulatory ability, and residual use of orthoses); and (3) complications between patients undergoing combined periarticular contracture releases and bony procedures with and without external oblique abdominal muscle transfers.Between 2004 and 2013, 14 pediatric patients (16 hips) were treated for hip instability

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2015 Clinical Orthopaedics and Related Research

93. Arsenic is associated with reduced effect of folic acid in myelomeningocele prevention: a case control study in Bangladesh (PubMed)

Arsenic is associated with reduced effect of folic acid in myelomeningocele prevention: a case control study in Bangladesh Arsenic induces neural tube defects in several animal models, but its potential to cause neural tube defects in humans is unknown. Our objective was to investigate the associations between maternal arsenic exposure, periconceptional folic acid supplementation, and risk of posterior neural tube defect (myelomeningocele) among a highly exposed population in rural (...) Bangladesh.We performed a case-control study that recruited physician-confirmed cases from community health clinics served by Dhaka Community Hospital in Bangladesh, as well as local health facilities that treat children with myelomeningocele. Controls were selected from pregnancy registries in the same areas. Maternal arsenic exposure was estimated from drinking water samples taken from wells used during the first trimester of pregnancy. Periconceptional folic acid use was ascertained by self-report

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2015 Environmental Health

94. Molecular signature of amniotic fluid derived stem cells in the fetal sheep model of myelomeningocele. (PubMed)

Molecular signature of amniotic fluid derived stem cells in the fetal sheep model of myelomeningocele. Abnormal cord development results in spinal cord damage responsible for myelomeningocele (MMC). Amniotic fluid-derived stem cells (AFSCs) have emerged as a potential candidate for applications in regenerative medicine. However, their differentiation potential is largely unknown as well as the molecular signaling orchestrating the accurate spinal cord development. Fetal lambs underwent surgical

2015 Journal of Pediatric Surgery

95. Flow patterns in the ductus arteriosus during open fetal myelomeningocele repair. (PubMed)

Flow patterns in the ductus arteriosus during open fetal myelomeningocele repair. The objective of this study is to perform a longitudinal evaluation of blood flow patterns in the ductus arteriosus (DA) during the perioperative period in fetal myelomeningocele (MMC) surgical patients.Serial fetal echocardiograms were reviewed in 10 MMC cases where mothers received indomethacin and intravenous and inhaled anesthesia. One-way analysis of variance was utilized to evaluate for differences in peak

2015 Prenatal diagnosis

96. Bladder Function After Fetal Surgery for Myelomeningocele. (PubMed)

Bladder Function After Fetal Surgery for Myelomeningocele. A substudy of the Management of Myelomeningocele Study evaluating urological outcomes was conducted.Pregnant women diagnosed with fetal myelomeningocele were randomly assigned to either prenatal or standard postnatal surgical repair. The substudy included patients randomly assigned after April 18, 2005. The primary outcome was defined in their children as death or the need for clean intermittent catheterization (CIC) by 30 months of age (...) . The implications of these findings are unclear now, but support the need for long-term urologic follow-up of patients with myelomeningocele regardless of type of surgical repair.Copyright © 2015 by the American Academy of Pediatrics.

2015 Pediatrics

97. Position statement on fetal myelomeningocele repair. (PubMed)

Position statement on fetal myelomeningocele repair. Following the promising multicenter randomized trial results of in utero fetal myelomeningocele repair; we anticipate that an increasing number of tertiary care centers may want to offer this therapy. It is essential to establish minimum criteria for centers providing open fetal myelomeningocele repair to ensure optimal maternal and fetal/pediatric outcomes, as well as patient safety both short- and long-term; and to advance our knowledge (...) of the role and benefit of fetal surgery in the management of fetal myelomeningocele. The fetal myelomeningocele Maternal-Fetal Management Task Force was initially convened by the Eunice Kennedy Shriver National Institute of Child Health and Human Development to discuss the implementation of maternal fetal surgery for myelomeningocele. The decision was made to develop the optimal practice criteria presented in this document for the purpose of medical and surgical leadership. These criteria

2014 American Journal of Obstetrics and Gynecology

98. In utero repair of myelomeningocele with autologous amniotic membrane in the fetal lamb model. (PubMed)

In utero repair of myelomeningocele with autologous amniotic membrane in the fetal lamb model. Despite advances in prenatal repair, myelomeningocele (MMC) still produces devastating neurologic deficits. The amniotic membranes (AM) are a biologically active tissue that has been used anecdotally for human fetal MMC repair. This study evaluated the use of autologous AM compared to skin closure in an established fetal MMC model.Seven fetal lambs underwent surgical creation of MMC at gestational age

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2014 Journal of Pediatric Surgery

99. Genetic variations in the GLUT3 gene associated with myelomeningocele. (PubMed)

Genetic variations in the GLUT3 gene associated with myelomeningocele. Our objectives were to examine the extent of described sequence variation in the glucose transporter 3 (GLUT3) gene in children with myelomeningocele (MM), identify novel variations in the GLUT3 gene in these children, and determine whether these variations may confer a risk of MM.We sequenced the 10 exons of GLUT3, including exon-intron boundaries, on 96 children with MM. Sequencing was performed with Sanger methods

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2014 American Journal of Obstetrics and Gynecology

100. Functional electrical stimulation for management of urinary incontinence in children with myelomeningocele: a randomized trial. (PubMed)

Functional electrical stimulation for management of urinary incontinence in children with myelomeningocele: a randomized trial. To report the efficacy of transcutaneous functional electrical stimulation (FES) in children with refractory neuropathic urinary incontinence secondary to myelomeningocele (MMC).Thirty children with history of MMC (12 girls and 18 boys, mean age 6.7 ± 3.6 years) with refractory urinary incontinence were enrolled in this study. They were randomly allocated to treatment (...) variables, DLPP increased significantly from 32 ± 10.7 cmH2O before treatment to 55.6 ± 24.9 cmH2O in treatment group after 6 months (P < 0.03). Daily incontinence score (range 0-3) improved significantly in treatment group from 2.7 ± 0.4 before treatment to 1.3 ± 0.9 after treatment compared with sham stimulation group (P < 0.02).This type of electrical stimulation is a safe, noninvasive, and effective modality to improve urinary incontinence in myelomeningocele children and can be used at home.

2014 Pediatric surgery international

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