Therapeutic conducts for myelomeningocele

Authors

DOI:

https://doi.org/10.33448/rsd-v11i6.28983

Keywords:

Consequence Analysis; Teaching; Spina bifida.

Abstract

Objective: The present work aims to explain about myelomeningocele and compare its therapeutic options. Methodology: A bibliographic review research was carried out, based on the PubMed search platform, in which a filtering process was carried out to select and exclude sources. Results and discussion: Myelomeningocele is the main central nervous system anomaly that may have fetal surgery as a therapeutic option. MMC brings with it several postnatal consequences, such as hydrocephalus and paraplegia, and directly affects morbidity and mortality. It is considered a multifactorial pathology, which has several risk factors associated with its origin, such as genetic alterations and folate deficiency. MMC can manifest in all body systems and the severity varies depending on the location of the injury. The diagnosis of MMC is made through laboratory and imaging tests. There are three therapeutic options for a myelomeningocele: termination of pregnancy, intrauterine repair and postnatal repair. Fetal surgery can be performed by the open method or by fetoscope. Conclusion: All therapeutic options have their risks and benefits, it is up to the health team, together with the family, to decide the best alternative.

References

Cavalheiro, S., da Costa, M. D. S., Moron, A. F., & Leonard, J. (2017). Comparison of Prenatal and Postnatal Management of Patients with Myelomeningocele. Neurosurgery Clinics of North America, 28(3), 439–448. https://doi.org/10.1016/j.nec.2017.02.005

Danzer, E., Joyeux, L., Flake, A. W., & Deprest, J. (2019). Fetal surgical intervention for myelomeningocele: lessons learned, outcomes, and future implications. Developmental Medicine & Child Neurology, 62(4), 417–425. https://doi.org/10.1111/dmcn.14429

da Rocha, L. S. N., Bunduki, V., de Amorim Filho, A. G., Cardeal, D. D. Matushita, H., Fernandes, H. S., Nani, F. S., de Francisco, R. P. V., & de Carvalho, M. H. B. (2021). Open fetal myelomeningocele repair at a university hospital: surgery and pregnancy outcomes. Archives of Gynecology and Obstetrics, 304(6), 1443–1454. https://doi.org/10.1007/s00404-021-06066-y

Dewan, M. C., & Wellons, J. C. (2019). Fetal surgery for spina bifida. Journal of Neurosurgery: Pediatrics, 24(2), 105–114. https://doi.org/10.3171/2019.4.peds18383

Goodnight, W. H., Bahtiyar, O., Bennett, K. A., Emery, S. P., Lillegard, J. B., Fisher, A., Goldstein, R., Jatres, J., Lim, F.-Y., McCullough, L., Moehrlen, U., Heuer, G. G., Moldenhauer, J. S., & Scott Adzick, N. (2017). Prenatal surgery for myelomeningocele: review of the literature and future directions. Child’s Nervous System, 33(7), 1149–1155. https://doi.org/10.1007/s00381-017-3440-z

Horzelska, E. I., Zamlynski, M., Horzelski, T., Zamlynski, J., Pastuszka, A., Bablok, R., Herman-Sucharska, I., Koszutski, T., & Olejek, A. (2020). Open fetal surgery for myelomeningocele — is there the learning curve at reduction mother and fetal morbidity? Ginekologia Polska, 91(3), 123–131. https://doi.org/10.5603/gp.2020.0028

Joyeux, L., Danzer, E., Flake, A. W., & Deprest, J. (2018). Fetal surgery for spina bifida aperta. Archives of Disease in Childhood - Fetal and Neonatal Edition, 103(6), F589–F595. https://doi.org/10.1136/archdischild-2018-315143

Kabagambe, S. K., Jensen, G. W., Chen, Y. J., Vanover, M. A., & Farmer, D. L. (2017). Fetal Surgery for Myelomeningocele: A Systematic Review and Meta-Analysis of Outcomes in Fetoscopic versus Open Repair. Fetal Diagnosis and Therapy, 43(3), 161–174. https://doi.org/10.1159/000479505

Lapa, D. A. (2019). Endoscopic fetal surgery for neural tube defects. Best Practice & Research Clinical Obstetrics & Gynaecology, 58, 133–141. https://doi.org/10.1016/j.bpobgyn.2019.05.001

Licci, M., Guzman, R., & Soleman, J. (2019). Maternal and obstetric complications in fetal surgery for prenatal myelomeningocele repair: a systematic review. Neurosurgical Focus, 47(4), E11. https://doi.org/10.3171/2019.7.focus19470

Mazzone, L., Moehrlen, U., Casanova, B., Ryf, S., Ochsenbein-Kölble, N., Zimmermann, R., Kraehenmann, F., & Meuli, M. (2018). Open Spina Bifida: Why Not Fetal Surgery? Fetal Diagnosis and Therapy, 45(6), 430–434. https://doi.org/10.1159/000491751

Moldenhauer, J. S., & Adzick, N. S. (2017). Fetal surgery for myelomeningocele: After the Management of Myelomeningocele Study (MOMS). Seminars in Fetal and Neonatal Medicine, 22(6), 360–366. https://doi.org/10.1016/j.siny.2017.08.004

Moldenhauer, J. S., Moon-Grady, A. J., Ruano, R., Skupski, D. W., Thom, E., Treadwell, M. C., Tsao, K., Wagner, A. J., & Waqar, L. N. (2019). Subsequent pregnancy outcomes after open maternal-fetal surgery for myelomeningocele. American Journal of Obstetrics and Gynecology, 220(5), 494.e1–494.e7. https://doi.org/10.1016/j.ajog.2019.03.008

Munoz, J. L., Bishop CNM, E., Reider, M., Radeva, M., Hsich, G., & Singh, K. (2020). Fetal myelomeningocele diagnosed in the antenatal period: Maternal-fetal characteristics and their relationship with pregnancy decision-making. Journal of Neonatal-Perinatal Medicine, 12(4), 399–403. https://doi.org/10.3233/npm-180208

Pan, Evelyn T., Pallapati, J., Krueger, A., Yepez, M., VanLoh, S., Nassr, Ahmed A., Espinoza, J., Shamshirsaz, Alireza A., Olutoye, Oluyinka O., Mehollin-Ray, A., de Jong, H., Castillo, H., Castillo, J., Whitehead, William E., Olutoye, Olutoyin A., Ayres, N., Belfort, Michael A., & Sanz Cortes, M. (2019). Evaluation and Disposition of Fetal Myelomeningocele Repair Candidates: A Large Referral Center Experience. Fetal Diagnosis and Therapy, 47(2), 115–122. https://doi.org/10.1159/000500451

Rocque, B. G., Hopson, B. D., & Blount, J. P. (2021). Caring for the Child with Spina Bifida. Pediatric Clinics of North America, 68(4), 915–927. https://doi.org/10.1016/j.pcl.2021.04.013

Sacco, A., Ushakov, F., Thompson, D., Peebles, D., Pandya, P., De Coppi, P., Wimalasundera, R., Attilakos, G., David, A. L., & Deprest, J. (2019). Fetal surgery for open spina bifida. The Obstetrician & Gynaecologist, 21(4), 271–282. https://doi.org/10.1111/tog.12603

Sanz Cortes, M., Davila, I., Torres, P., Yepez, M., Lee, W., Guimaraes, C. V., Sangi-Haghpeykar, H., Whitehead, W. E., Castillo, J., Nassr, A. A., Espinoza, J.,

Shamshirsaz, A. A., & Belfort, M. A. (2019). Does fetoscopic or open repair for spina bifida affect fetal and postnatal growth? Ultrasound in Obstetrics & Gynecology, 53(3), 314–323. https://doi.org/10.1002/uog.20220

Sepulveda, W., Wong, A. E., Sepulveda, F., Alcalde, J. L., Devoto, J. C., & Otayza, F. (2017). Prenatal diagnosis of spina bifida: from intracranial translucency to intrauterine surgery. Child’s Nervous System, 33(7), 1083–1099. https://doi.org/10.1007/s00381-017-3445-7

Yamashiro, K. J., Galganski, L. A., & Hirose, S. (2019). Fetal myelomeningocele repair. Seminars in Pediatric Surgery, 28(4), 150823. https://doi.org/10.1053/j.sempedsurg.2019.07.006

Downloads

Published

30/04/2022

How to Cite

ALMEIDA, M. C. de; VELOSO, M. L.; CAMILO, J. C. M.; SPÓSITO, T. S. L.; PACHECO, L. G.; PACHECO, G. G.; MOURA, F. V. L. e. Therapeutic conducts for myelomeningocele. Research, Society and Development, [S. l.], v. 11, n. 6, p. e34711628983, 2022. DOI: 10.33448/rsd-v11i6.28983. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/28983. Acesso em: 24 dec. 2024.

Issue

Vol. 11 No. 6

Section

Health Sciences

License

Copyright (c) 2022 Mileny Costa de Almeida; Maria Laura Veloso; Júlio César Merli Camilo; Tiago Salerno Lemos Spósito; Leonardo Garcia Pacheco; Gustavo Garcia Pacheco; Francini Viscondi Lopes e Moura

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.