Denise Araújo Lapa Pedreira

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BACKGROUND A recent randomized clinical trial named Management of Myelomeningocele Study (MOMS trial) showed that prenatal correction of open spina bifida (OSB) via open fetal surgery was associated with improved infant neurological outcomes relative to postnatal repair, but at the expense of increased maternal morbidity. OBJECTIVE We sought to report the(More)
OBJECTIVE To investigate presence of trisomy in amniotic epithelium (uncultured amnion) and mesenchyme (cultured amnion) from mosaic cases to understand the origins of these tissues and their relationship to pregnancy outcome. METHODS Polymerase chain reaction (PCR) of microsatellite loci was used to determine the presence of trisomy (of meiotic origin(More)
OBJECTIVE To report our preliminary clinical experience in the antenatal correction of open spina bifida (OSB) using a fetoscopic approach and a simplified closure technique. METHODS Four fetuses with lumbar-sacral defects were operated in utero from 25 to 27 weeks. Surgeries were performed percutaneously under general anesthesia using three trocars and(More)
PURPOSE The aim of this study was to compare the effectiveness of two dura-mater substitutes, namely human acellular dermal matrix (HADM) and biosynthetic cellulose (BC), in repairing, in utero, surgically-induced meningomyelocele (MMC) in fetal sheep. METHODS A neural tube defect was created at 74-77 days gestation in 36 fetal sheep. They were divided(More)
OBJECTIVE To compare the classical neurosurgical technique with a new simplified technique for prenatal repair of a myelomeningocele-like defect in sheep. METHODS A myelomeningocele-like defect (laminectomy and dural excision) was created in the lumbar region on day 90 of gestation in 9 pregnant sheep. Correction technique was randomized. In Group 1 the(More)
OBJECTIVE To evaluate the fetal survival rate using a modified technique to surgically create a 'myelomeningocele-like' defect in a rabbit model. METHODS Six white New Zealand rabbits had a spinal defect created in their fetuses at 23 days of gestation. At 30 days of gestation, the fetuses were harvested for anatomo-pathologic evaluation. RESULTS The(More)
OBJECTIVE To develop a new endoscopic approach to the correction of a myelomeningocele-like defect in fetal sheep. METHODS The fetuses of 9 pregnant ewes, with an average gestational age of 115 days, were subjected to a 3.0 x 2.0 cm removal of the skin over the lumbar spine, performed through hysterotomy. The uterus was closed, and three 5-mm endoscopic(More)
OBJECTIVE To assess the ability of a three-layer graft in the closuse of large fetal skin defects. METHODS Ovine fetuses underwent a large (4 × 3 cm) full-thickness skin defect over the lumbar region at 105 days' gestation (term = 140 days). A bilaminar artificial skin was placed over a cellulose interface to cover the defect (3-layer graft). The skin was(More)
PURPOSE To produce a myelomeningocele-like human defect in the ovine fetus and validate this experimental model in our population. METHODS A prospective study on 12 pregnant sheep of a crossed Hampshire/Down breed where a spinal defect was surgically created between Day 75 and Day 77 after conception. The technique consisted of a hysterotomy with exposure(More)