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Assessment of neurosurgical outcome in children prenatally diagnosed with myelomeningocele and development of a protocol for fetal surgery to prevent hydrocephalus.
Zambelli, Helder; Carelli, Edmur; Honorato, Donizeti; Marba, Sérgio; Coelho, Giselle; Carnevalle, Aline; Iscaife, Alexandre; da Silva, Elton; Barini, Ricardo; Sbragia, Lourenço.
Afiliação
  • Zambelli H; Discipline of Neurosurgery-Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, Campinas-SP, Brazil. hzambelli@uol.com.br
Childs Nerv Syst ; 23(4): 421-5, 2007 Apr.
Article em En | MEDLINE | ID: mdl-17226038
INTRODUCTION: Prenatal diagnosis of myelomeningocele (MMC) has permitted a better planning for optimum management of the disease. More recently, it has allowed for a possible intrauterine repair of the spinal defect. OBJECTIVE: To describe neurosurgical outcome in children with myelomeningocele and follow-up at a referral center in Fetal Medicine. Patients were characterized for the development of a protocol suitable for fetal surgery, and fetuses who were possible candidates for intrauterine surgery were identified. MATERIALS AND METHODS: A retrospective descriptive analysis was performed of 98 cases of fetal myelomeningocele, seen at CAISM-UNICAMP, from January 1994 to December 2002, identifying cases with a possible indication for fetal surgery. RESULTS: Mean gestational age at diagnosis was 29 weeks (17-39); level of lesion was above the sacral region in 92.84%; association with hydrocephalus occurred in 78.57%. During clinical course, 82.5% of patients had neurogenic bladder and 60% had neural and mental deficits. Potential intrauterine repair rate was 11.57%, using criteria from the protocol developed in our service. CONCLUSION: Myelomeningocele is associated with severe and frequent sequelae. In virtually 12% of our cases, fetal surgery could have been offered as a therapeutic option.
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Meningomielocele / Resultado do Tratamento / Doenças Fetais / Neurocirurgia Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Infant / Male / Pregnancy Idioma: En Revista: Childs Nerv Syst Assunto da revista: NEUROLOGIA / PEDIATRIA Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha
Buscar no Google
Adicionar na Minha BVS
Imprimir
XML
PubMed Links

Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Meningomielocele / Resultado do Tratamento / Doenças Fetais / Neurocirurgia Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Infant / Male / Pregnancy Idioma: En Revista: Childs Nerv Syst Assunto da revista: NEUROLOGIA / PEDIATRIA Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha