Prenatal surgery for myelomeningocele: review of the literature and future directions

Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery
Gregory G HeuerN Scott Adzick

Abstract

Open spina bifida or myelomeningocele (MMC) is one of the most common serious congenital malformations. Historically, this condition has been treated with closure of the MMC defect shortly after birth. The goal of postnatal closure is to cover the exposed spinal cord and prevent infection. However, postnatal surgery does not reverse or prevent the neurologic injury seen in MMC, reverse hindbrain herniation, or prevent hydrocephalus. The neurologic defects result from primary incomplete neurulation and secondary chronic prenatal damage to the exposed neural elements through mechanical and chemical trauma. In a hope to reduce the numerous surgical procedures, medical complications, and lifelong disabilities associated with MMC, the proposal of prenatal closure was put forth more than two decades ago. After promising results in animal models and some clinical series, a randomized controlled trial, the Management of Myelomeningocele Study (MOMS), was conducted. The MOMS trial demonstrated that closure during the prenatal period could be performed relatively safely and can result in significant benefit to the child. Specifically, prenatal closure results in improved motor function, reduced hindbrain herniation, and reduced need for ...Continue Reading

References

Jan 1, 1989·Pediatric Neuroscience·D G McLone, P A Knepper
Sep 1, 1987·The Journal of Pediatrics·E B CharneyL Schut
Dec 1, 1986·Journal of Neurosurgery·R M ScottG T Klauber
Dec 1, 1983·Journal of Neurosurgery·J F Martinez-LageM Poza
Mar 1, 1993·Pediatric Neurosurgery·W M Chadduck, G J Roloson
Dec 16, 1998·Lancet·N S AdzickA W Flake
Jan 23, 1999·American Journal of Obstetrics and Gynecology·J P BrunerT L Arney
Nov 26, 1999·JAMA : the Journal of the American Medical Association·J P BrunerG W Reed
Jun 27, 2000·Pediatric Neurosurgery·K J MangelsJ P Bruner
Jul 26, 2002·The New England Journal of Medicine·Catherine A MazzolaIan F Pollack
Aug 13, 2003·Fetal Diagnosis and Therapy·R Douglas WilsonN Scott Adzick
Aug 16, 2003·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·David G McLone, Mark S Dias
Aug 23, 2005·Fetal Diagnosis and Therapy·A J EgginkP P van den Berg
Jun 23, 2009·Seminars in Fetal & Neonatal Medicine·N Scott Adzick
Aug 19, 2009·Prenatal Diagnosis·Margaret R HüslerR Douglas Wilson
Feb 11, 2011·The New England Journal of Medicine·N Scott AdzickUNKNOWN MOMS Investigators
Mar 1, 2011·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Cesar G FontechaVicente Martinez
Aug 19, 2011·Fetal Diagnosis and Therapy·Enrico Danzer, N Scott Adzick
Sep 20, 2011·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Benjamin C Warf
Oct 25, 2011·AJR. American Journal of Roentgenology·Tamara T ChaoDiane M Twickler
Dec 1, 2011·Developmental Medicine and Child Neurology·Renate J VerbeekDeborah A Sival
Mar 3, 2012·Journal of Neurosurgery. Pediatrics·Nalin GuptaDiana Farmer
Jun 26, 2012·The Journal of Pediatrics·Mikyong ShinAdolfo Correa
Feb 12, 2013·Seminars in Pediatric Surgery·N Scott Adzick
Sep 24, 2013·American Journal of Obstetrics and Gynecology·Alan R CohenUNKNOWN MMC Maternal-Fetal Management Task Force
Apr 23, 2014·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·J DegenhardtT Kohl
Jul 1, 2014·Birth Defects Research. Part A, Clinical and Molecular Teratology·Vijaya KancherlaGodfrey P Oakley
Aug 21, 2014·Fetal Diagnosis and Therapy·Julie S MoldenhauerN Scott Adzick
Aug 30, 2014·Fetal Diagnosis and Therapy·Gregory G HeuerLeslie N Sutton
Nov 5, 2014·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·A Flake
Jul 18, 2015·Pediatric Neurosurgery·Jayesh P ThawaniGregory G Heuer
Sep 16, 2015·Journal of Neurosurgery. Pediatrics·Noel TulipanUNKNOWN for the MOMS Investigators
Sep 20, 2015·American Journal of Obstetrics and Gynecology·Denise A L PedreiraRubén A Quintero
Sep 30, 2015·Pediatrics·John W BrockUNKNOWN MOMS Investigators
Dec 5, 2015·Journal of Neurosurgery. Pediatrics·Jay Riva-CambrinUNKNOWN Hydrocephalus Clinical Research Network
Dec 23, 2015·American Journal of Obstetrics and Gynecology·Shelly SoniN Scott Adzick

❮ Previous
Next ❯

Citations

Jun 27, 2018·Echocardiography·Eduardo Félix Martins SantanaSérgio Cavalheiro
Jun 22, 2019·Operative Neurosurgery·Tracy M FlandersGregory G Heuer
Jul 13, 2019·Cambridge Quarterly of Healthcare Ethics : CQ : the International Journal of Healthcare Ethics Committees·Julia A E RadicPatrick J McDonald
Oct 2, 2019·Neurosurgical Focus·Giorgio CarrabbaNicola Persico
Sep 19, 2020·AJNR. American Journal of Neuroradiology·R A DidierB G Coleman
Apr 30, 2020·Annals of Plastic Surgery·Owen H BrownChristian J Vercler
Feb 23, 2021·Intractable & Rare Diseases Research·Mohamad MoussaAthanasios Dellis
Mar 21, 2021·Stem Cell Reviews and Reports·Alireza Soltani KhaboushanMasoumeh Majidi Zolbin
Oct 10, 2018·Fetal Diagnosis and Therapy·Huseyin CanazAli Gedikbasi
Jan 26, 2020·Pediatrics·Amy J HoutrowWilliam O Walker

❮ Previous
Next ❯

Related Concepts

Related Feeds

CSF & Lymphatic System

This feed focuses on Cerebral Spinal Fluid (CSF) and the lymphatic system. Discover the latest papers using imaging techniques to track CSF outflow into the lymphatic system in animal models.

Related Papers

American Journal of Perinatology
Julie S Moldenhauer
Fetal Diagnosis and Therapy
Gregory G HeuerLeslie N Sutton
Seminars in Pediatric Surgery
N Scott Adzick, Danielle S Walsh
© 2022 Meta ULC. All rights reserved