Journal article

Authors list: Diehl, D.; Belke, F.; Kohl, T.; Axt-Fliedner, R.; Degenhardt, J.; Khaleeva, A.; Oehmke, F.; Faas, D.; Ehrhardt, H.; Kolodziej, M.; Uhl, E.; Windhorst, A. C.; Neubauer, B. A.

Publication year: 2021

Pages: 113-118

Journal: Ultrasound in Obstetrics & Gynecology

Volume number: 57

Issue number: 1

ISSN: 0960-7692

eISSN: 1469-0705

Open access status: Hybrid

DOI Link: https://doi.org/10.1002/uog.22116

Publisher: Wiley

Abstract: 

Objective: This observational study reports on the postnatal mortality and 30-month outcome of children who underwent fully percutaneous fetoscopic repair of myelomeningocele (MMC) at a single center in Giessen, Germany.

Methods: Between October 2010 and August 2014, a total of 72 patients underwent fully percutaneous fetoscopic MMC closure at 21 + 0 to 29 + 1 (mean, 23 + 5) weeks' gestation. Of these, 52 (72%) participated in this study; however, 30-month mortality data are available for all 72 children. Children were examined at four timepoints: shortly after birth and at 3 months, 12 months and 30 months of corrected age. The patients underwent age-specific standardized neurological examinations and assessment of leg movements and ambulation at all timepoints. Cognitive and motor development were assessed using the Bayley Scales of Infant Development, second edition (BSID-II), at 30 months.

Results: All 72 children survived the intrauterine procedure, however, four (5.6%) infants died postnatally (including two of the 52 comprising the study cohort). Of the 52 patients included in the study, 11.5% were delivered before the 30th week of gestation (mean, 33 + 1 weeks) and, of the survivors, 48.1% had ventriculoperitoneal shunt placement. Of the 50 infants that were alive at 30 months, independent ambulation, without orthosis, was feasible for 46%. At 30 months of follow-up, 46% of children presented with a functional level that was at least two segments better than the anatomical level of the lesion. At 30 months, 70% of the children presented with BSID-II psychomotor development index score of >= 70 and 80% with BSID-II mental development index score of >= 70.

Conclusion: Intrauterine repair of MMC by percutaneous fetoscopy shows largely similar outcomes to those reported for open repair, with respect to mortality, prematurity, shunt-placement rates, motor and mental development and free ambulation. (C) 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Harvard Citation style: Diehl, D., Belke, F., Kohl, T., Axt-Fliedner, R., Degenhardt, J., Khaleeva, A., et al. (2021) Fully percutaneous fetoscopic repair of myelomeningocele: 30-month follow-up data, Ultrasound in Obstetrics & Gynecology, 57(1), pp. 113-118. https://doi.org/10.1002/uog.22116

APA Citation style: Diehl, D., Belke, F., Kohl, T., Axt-Fliedner, R., Degenhardt, J., Khaleeva, A., Oehmke, F., Faas, D., Ehrhardt, H., Kolodziej, M., Uhl, E., Windhorst, A., & Neubauer, B. (2021). Fully percutaneous fetoscopic repair of myelomeningocele: 30-month follow-up data. Ultrasound in Obstetrics & Gynecology. 57(1), 113-118. https://doi.org/10.1002/uog.22116