Prenatal Repair of Spina Bifida: A 2-Center Experience with Open Intrauterine Neurosurgery in Chile.

Objective: To report the experience with prenatal repair of open spina bifida (OSB) from 2 centers in Chile.

Methods: Women with a second-trimester fetus with OSB were offered intrauterine neurosurgical repair following the protocol from the Management of Myelomeningocele Study (MOMS) trial. Pediatric follow-up with infants reaching 12 and 30 months of life was also reviewed.

Prenatal diagnosis of spina bifida: from intracranial translucency to intrauterine surgery.

Accurate and timely prenatal diagnosis of spina bifida (SB) is a major goal of modern antenatal care. Prenatal screening for open SB should be first performed at the time of routine first-trimester ultrasound by examining the posterior fossa for obliteration or non-visualization of the fourth ventricle ("intracranial translucency") and cisterna magna. The second step of screening is the second-trimester anatomy scan, at which time the features of the Chiari type II malformation should be looked for, including ventriculomegaly, scalloping of the frontal bones ("lemon" sign), and backward and caudal displacement of the cerebellar vermis with obliteration of the cisterna magna ("banana" sign).

Anesthesia for myelomeningocele surgery in fetus.

Background: Administering anesthesia for prenatal repair of myelomeningocele reveals several issues that are unique to this new form of treatment. This includes issues such as fetal well-being, surgical conditions and monitoring, among others. Exploring, analyzing, and understanding the different variables that are involved will help us reduce the high level of risk associated with this surgery.

Endoscopic laser coagulation of feeding vessels in large placental chorioangiomas: report of three cases and review of invasive treatment options.

Objective: To report three cases of large placental chorioangiomas managed with endoscopic laser coagulation of the feeding vessels, and review the literature regarding cases of chorioangioma treated with invasive techniques.

Methods: Intrauterine endoscopic surgery was performed using a 2.5-mm fetoscope under epidural anesthesia.

Endoscopic laser surgery in severe second-trimester twin-twin transfusion syndrome: a three-year experience from a Latin American center.

Objective: In order to assess the outcome of pregnancies complicated by severe second trimester twin-twin transfusion syndrome (TTTS) undergoing treatment with endoscopic laser surgery, we reviewed our experience following the implementation of an institutional fetal surgery program.

Methods: Patients presenting with monochorionic-diamniotic twin pregnancies complicated by severe TTTS before 26 weeks of gestation were offered endoscopic laser surgery to coagulate placental vascular anastomoses. Using regional anesthesia and guided by real-time sonography, anastomoses were identified and selectively coagulated.