Current Status and Prospects of Fetoscopic Surgery for Spina Bifida in Human Fetuses

@article{Kohl2008CurrentSA,
  title={Current Status and Prospects of Fetoscopic Surgery for Spina Bifida in Human Fetuses},
  author={Thomas Kohl and Ulrich Gembruch},
  journal={Fetal Diagnosis and Therapy},
  year={2008},
  volume={24},
  pages={318 - 320}
}
Over the last 4 years, our center has established a protocol specially tailored to the needs of minimally invasive fetoscopic interventions that permits general maternofetal anesthesia for up to 8 h, if needed [4] . Employing the protocol, sufficient tocolysis and uterine relaxation has been achieved, and adequate uterine and fetoplacental blood flows can be maintained. A mild case of maternal pulmonary edema was seen in only 1 of more than 50 patients. With regard to fetal safety, neither… Expand
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The tribulations and trials of fetal surgery for spina bifida.
  • N. Adzick
  • Medicine
  • Proceedings of the American Philosophical Society
  • 2013
TLDR
The promise of fetal surgery is that the earliest possible intervention for a life-threatening or disabling fetal disorder may produce the best results. Expand
Fetal surgery for spina bifida: past, present, future.
  • N. Adzick
  • Medicine
  • Seminars in pediatric surgery
  • 2013
TLDR
F fetal surgery for MMC before 26 weeks' gestation may preserve neurologic function, reverse the hindbrain herniation of the Chiari II malformation, and obviate the need for postnatal placement of a ventriculoperitoneal shunt, but it is demonstrated that fetal surgery is associated with significant risks related to the uterine scar and premature birth. Expand
Fetal Surgery for Myelomeningocele : Trials and Tribulations
The rationale for in utero repair of myelomeningocele (MMC) in the context of pathologic observations, animal models, and outcomes from the initial experience with human fetal myelomeningocele repair… Expand
Fetal surgery for myelomeningocele: trials and tribulations. Isabella Forshall Lecture.
  • N. Adzick
  • Medicine
  • Journal of pediatric surgery
  • 2012
TLDR
The story is focused on the milestone contributions of members of the Center for Fetal Diagnosis and Treatment at the Children's Hospital of Philadelphia on the road to successful fetal surgery for spina bifida. Expand
Fetal Myelomeningocele Closure: Technical Considerations
TLDR
The goal of this paper is to describe the technique of fetal closure of MMC defects, highlight the unique steps that are needed for this surgery and delineate some potential pitfalls. Expand
Minimally invasive fetoscopic interventions: an overview in 2010
  • T. Kohl
  • Medicine
  • Surgical Endoscopy
  • 2010
TLDR
A growing spectrum of fetal disease states has become amenable to minimally invasive fetoscopic interventions and further improvements in fetal selection, surgical techniques, and postnatal management accompanied by the development of specialized devices are desired. Expand
Role of fetal surgery in spinal dysraphism
TLDR
It is concluded, in accordance with the MOMS investigators, that in utero surgery cannot be considered a standard option at present time despite promising results regarding central nervous system protection due to early spinal canal closure. Expand
Fetal surgery for myelomeningocele is effective: a critical look at the whys
TLDR
Despite the fact that in utero repair of MMC is not a complete cure and not free of risk for both mother and fetus, current data clearly demonstrate that open fetal–maternal surgery is to be recommended as novel standard of care when pregnancies are to be continued and when respective criteria for the intervention before birth are met. Expand
Fetal surgery for myelomeningocele: a critical appraisal.
  • M. Meuli, U. Moehrlen
  • Medicine
  • European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie
  • 2013
TLDR
The conclusion derived from all data existing today is that maternal-fetal surgery, although not a cure and not free of risks, represents a novel standard of care for select mothers and their fetuses suffering from one of the most ruinous nonlethal congenital malformations. Expand
Prenatal versus postnatal repair of myelomeningocele.
TLDR
It is agreed with Oba that, for patients with COPD who have high-risk cardiac conditions, there is incomplete clinical evidence regarding the comparative benefit-risk ratio of individual treatment options, and the question of which long-acting bronchodilator one should use first has been adequately addressed. Expand
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