PMID- 33254173
OWN - NLM
STAT- MEDLINE
DCOM- 20211124
LR  - 20211124
IS  - 1421-9964 (Electronic)
IS  - 1015-3837 (Linking)
VI  - 47
IP  - 12
DP  - 2020
TI  - Alternative Hysterotomy Technique for the Reduction of Prenatal Complications of 
      Intrauterine Myelomeningocele Repair.
PG  - 894-901
LID - 10.1159/000510815 [doi]
AB  - INTRODUCTION: The main aim of the fetal surgery of myelomeningocele (MMC) is the 
      improvement in prognosis for children with this defect and at the same time high 
      safety of the procedure for mother and fetus. OBJECTIVE: The aim of the study was 
      to determine the effectiveness of alternative hysterotomy technique for fetal 
      surgery of MMC in prevention of essential perinatal complications. METHODS: 
      Forty-nine pregnant women diagnosed with fetal MMC (fMMC) who underwent classic 
      hysterotomy without the use of stapler formed the study cohort. Two cases of 
      intrauterine fetal death or neonatal death in the immediate perioperative period 
      in the study group (SG) were excluded from further analyses. In the historical 
      control group (46 patients) from our center hysterotomy was performed according 
      to Management of Myelomeningocele Study (MOMS) protocol. The study cohort's 
      outcomes were compared with the historical controls and with post-MOMS results in 
      Children's Hospital of Philadelphia (CHOP) and Vanderbilt University Medical 
      Center (VUMC). RESULTS: In the SG we did not observe delivery before 30 weeks of 
      gestation (0/47; 0%) and the incidence of chorionamniotic membrane separation 
      (CMS, 3/47; 6%) and preterm premature rupture of membranes (PPROM, 7/47; 15%) was 
      lower compared to the other groups. Preterm delivery as a result of uterine 
      contractions occurred significantly less frequently in the SG (8/47; 17%). Fetal 
      surgery with classic hysterotomy resulted in rare use of magnesium sulfate (3/47; 
      6%). CONCLUSIONS: The alternative hysterotomy technique for fetal surgery of MMC 
      results in low occurrences of CMS, PPROM, preterm delivery, and the rare use of 
      tocolytics.
CI  - (c) 2020 S. Karger AG, Basel.
FAU - Olejek, Anita
AU  - Olejek A
AD  - Department of Gynecology, Obstetrics and Gynecologic Oncology, Medical University 
      of Silesia in Katowice, Bytom, Poland.
FAU - Horzelska, Ewa
AU  - Horzelska E
AD  - Department of Gynecology, Obstetrics and Gynecologic Oncology, Medical University 
      of Silesia in Katowice, Bytom, Poland, ewa1007@wp.pl.
FAU - Zamlynski, Jacek
AU  - Zamlynski J
AD  - Department of Gynecology, Obstetrics and Gynecologic Oncology, Medical University 
      of Silesia in Katowice, Bytom, Poland.
FAU - Horzelski, Tomasz
AU  - Horzelski T
AD  - Department of Gynecology, Obstetrics and Gynecologic Oncology, Medical University 
      of Silesia in Katowice, Bytom, Poland.
FAU - Zamlynski, Mateusz
AU  - Zamlynski M
AD  - Department of Gynecology, Obstetrics and Gynecologic Oncology, Medical University 
      of Silesia in Katowice, Bytom, Poland.
FAU - Nowak, Leszek
AU  - Nowak L
AD  - Department of Gynecology, Obstetrics and Gynecologic Oncology, Medical University 
      of Silesia in Katowice, Bytom, Poland.
FAU - Pastuszka, Agnieszka
AU  - Pastuszka A
AD  - Department of Gynecology, Obstetrics and Gynecologic Oncology, Medical University 
      of Silesia in Katowice, Bytom, Poland.
LA  - eng
PT  - Journal Article
DEP - 20201130
PL  - Switzerland
TA  - Fetal Diagn Ther
JT  - Fetal diagnosis and therapy
JID - 9107463
SB  - IM
MH  - Child
MH  - Female
MH  - *Fetal Membranes, Premature Rupture/etiology/prevention & control
MH  - *Fetal Therapies
MH  - Gestational Age
MH  - Humans
MH  - Hysterotomy/adverse effects
MH  - Infant, Newborn
MH  - *Meningomyelocele/surgery
MH  - Pregnancy
OTO - NOTNLM
OT  - Chorioamniotic membrane separation
OT  - Fetal surgery
OT  - Myelomeningocele
OT  - Open spina bifida
OT  - Preterm labor
OT  - Preterm premature rupture of membranes
EDAT- 2020/12/01 06:00
MHDA- 2021/11/25 06:00
CRDT- 2020/11/30 20:16
PHST- 2020/01/20 00:00 [received]
PHST- 2020/08/11 00:00 [accepted]
PHST- 2020/12/01 06:00 [pubmed]
PHST- 2021/11/25 06:00 [medline]
PHST- 2020/11/30 20:16 [entrez]
AID - 000510815 [pii]
AID - 10.1159/000510815 [doi]
PST - ppublish
SO  - Fetal Diagn Ther. 2020;47(12):894-901. doi: 10.1159/000510815. Epub 2020 Nov 30.