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Open fetal myelomeningocele repair at a university hospital: surgery and pregnancy outcomes.
da Rocha, Luana Sarmento Neves; Bunduki, Victor; de Amorim Filho, Antônio Gomes; Cardeal, Daniel Dante; Matushita, Hamilton; Fernandes, Hermann Santos; Nani, Fernando Souza; de Francisco, Rossana Pulcineli Vieira; de Carvalho, Mário Henrique Burlacchini.
Afiliação
  • da Rocha LSN; Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 255 - 10° andar - Cerqueira Cesar, Sao Paulo, CEP 05403-000, Brazil.
  • Bunduki V; Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 255 - 10° andar - Cerqueira Cesar, Sao Paulo, CEP 05403-000, Brazil.
  • de Amorim Filho AG; Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 255 - 10° andar - Cerqueira Cesar, Sao Paulo, CEP 05403-000, Brazil.
  • Cardeal DD; Disciplina de Neurocirurgia, Departamento de Neurologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, BR, Brazil.
  • Matushita H; Disciplina de Neurocirurgia, Departamento de Neurologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, BR, Brazil.
  • Fernandes HS; Disciplina de Anestesiologia, Departamento de Cirurgia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, BR, Brazil.
  • Nani FS; Disciplina de Anestesiologia, Departamento de Cirurgia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, BR, Brazil.
  • de Francisco RPV; Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 255 - 10° andar - Cerqueira Cesar, Sao Paulo, CEP 05403-000, Brazil.
  • de Carvalho MHB; Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 255 - 10° andar - Cerqueira Cesar, Sao Paulo, CEP 05403-000, Brazil. mario.burlacchini@hc.fm.usp.br.
Arch Gynecol Obstet ; 304(6): 1443-1454, 2021 12.
Article em En | MEDLINE | ID: mdl-33932174
PURPOSE: Myelomeningocele (MMC) is an open neural tube defect that causes great morbidity. Prenatal open repair is the standard treatment; however, there are many complications related to the procedure. This study reports preliminary findings of open in utero repair of MMC in a public tertiary hospital in Brazil and describes factors that could be associated with increased surgical morbidity. METHODS: Thirty-nine patients underwent open in utero repair of MMC from October 2015 to August 2019. The Clavien-Dindo classification of surgical complications and a classification system with the preterm definitions of the World Health Organization were used, respectively, for maternal and fetal complications. RESULTS: A total of 28 mothers (71.8%) and 31 fetuses (79.5%) experienced at least one minor to major complication. Three mothers (7.7%) had a severe grade 4 complication. Fetal complications grades 3 to 5 occurred in 13 fetuses (33.3%). Gestational age at surgery and at birth were 24.88 ± 1.16 weeks and 33.23 ± 3.68 weeks, respectively. Preterm delivery occurred in 30 patients (76.9%), membrane rupture in 18 patients (46.2%) and chorioamnionitis in 13 patients (33.3%). CONCLUSION: Open fetal surgery for MMC was performed at a Brazilian public tertiary care center, resulting in three grade 4 maternal complications. Relevant fetal complications were also present. The use of a standard classification system for complications renders studies more comparable and data more useful for counseling patients. Adjustments of perioperative procedures and long-term follow-up are needed to determine the real benefit of open in utero repair of MMC at our hospital.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Disrafismo Espinal / Meningomielocele / Feto / Hidrocefalia / Defeitos do Tubo Neural Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Female / Humans / Newborn / Pregnancy Idioma: En Revista: Arch Gynecol Obstet Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Disrafismo Espinal / Meningomielocele / Feto / Hidrocefalia / Defeitos do Tubo Neural Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Female / Humans / Newborn / Pregnancy Idioma: En Revista: Arch Gynecol Obstet Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha