In a recently completed randomized, prospective clinical trial, fetal repair for myelomeningocele was shown to result in reduced rates of hydrocephalus requiring placement of a ventriculoperitoneal shunt, improvement in Chiari malformation Type II, and improvement in neurological function compared with standard postnatal repair. Successful fetal surgery requires the active participation and interaction of several clinical teams. Each group has a specific role, and overlap is often required at different points of the treatment plan. Extensive multispecialty discussions with the patient and family are necessary before informed consent can be obtained. Fetal surgery carries significant risks to the mother and fetus and these must be carefully considered prior to a final treatment decision. This review will summarize the evaluation and treatment of patients undergoing fetal repair for myelomeningocele at one institution.
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http://dx.doi.org/10.3171/2011.12.PEDS11403 | DOI Listing |
Am J Med Genet A
January 2025
Children's Hospital of Philadelphia, Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, Philadelphia, Pennsylvania, USA.
We report a 28-year-old G2P0 at 24 weeks 5 days who presented for evaluation secondary to suspected skeletal dysplasia in her fetus. Fetal ultrasound imaging demonstrated foreshortened long bones by 9-10 weeks, multiple bowing deformities and fractures, 11 foreshortened paired ribs with fractures, decreased skull mineralization, frontal bossing, enlarged cavum septum pellucidi, and severe fetal growth restriction (< 2%). Findings were concerning for life limiting condition with thoracic circumference < 2.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Department of Surgery, Aga Khan Hospital, P.O. Box 2289, Dar Es Salaam, Tanzania; Department of Surgery, Aga Khan University, P.O. Box 38129, Dar Es Salaam, Tanzania.
Introduction: The urachus is a fetal canal that connects the allantois to the bladder and typically obliterates by the 6th month of gestation. Failure of the urachus to obliterate can result in urachal anomalies, which, in rare cases, may undergo malignant transformation.
Case Presentation: We present a case of a 13-year-old female who experienced hematuria, dysuria, and abdominal pain persisting for over 4 months.
Am J Reprod Immunol
January 2025
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Recurrent pregnancy loss (RPL) represents a complication of pregnancy occurring in 1%-3% of all couples trying to conceive. About 50%-60% of RPL cases remain idiopathic, therefore therapeutic strategies seem empirical and based on unproven evidence. We investigated the efficacy of corticosteroids in women with RPL.
View Article and Find Full Text PDFJ Obstet Gynaecol Res
January 2025
Department of Obstetrics and Gynecology, Takatsuki General Hospital, Takatsuki, Japan.
Lymphangioma causing pain during pregnancy is not widely reported, but surgical treatment was performed in each of the reported cases. In our patient, lesions arose in the retroperitoneal cavity and caused intense pain from 17 weeks of gestation. However, surgical treatment was considered difficult because of the location of the lesion.
View Article and Find Full Text PDFBrain Spine
March 2024
Clinic for Spine Surgery, Schoen Clinic Hamburg Eilbek, Academic Hospital of the University Medical Center Eppendorf, Hamburg, Germany.
Introduction: It is reasonable to assume that lumbar spinal stenosis (LSS) affects the cauda nerve roots also at night.
Research Question: Does microsurgical decompression influence sleep quality and position?
Materials And Methods: A study nurse interviewed 140 patients scheduled for LSS decompression using the Pittsburgh Sleep Quality Index (PSQI), Spinal Stenosis Measure (SSM), Numeric Rating Scale (NRS) for back and leg pain, Douleur Neuropathique (DN4), and Charlson Comorbidity Index. Epidemiologic and MRI data were collected along with self-reported rankings of preferred sleep positions (prone, supine, side, and fetal).
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