MOMS Plus: Single-Institution Review of Outcomes for Extended BMI Criteria for Open Fetal Repair of Myelomeningocele.
Adult
Body Mass Index
Colorado
Female
Fetal Therapies
/ adverse effects
Gestational Age
Health Status
Humans
Maternal Health
Meningomyelocele
/ diagnostic imaging
Obesity
/ complications
Obstetric Surgical Procedures
/ adverse effects
Perinatal Death
Postoperative Complications
/ mortality
Pregnancy
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Ventriculoperitoneal Shunt
MOMS Plus
Maternal obesity
Myelomeningocele
Myeloschisis
Neural tube defect
Open fetal surgery
Journal
Fetal diagnosis and therapy
ISSN: 1421-9964
Titre abrégé: Fetal Diagn Ther
Pays: Switzerland
ID NLM: 9107463
Informations de publication
Date de publication:
2019
2019
Historique:
received:
13
02
2019
accepted:
07
03
2019
pubmed:
3
5
2019
medline:
28
4
2020
entrez:
4
5
2019
Statut:
ppublish
Résumé
In utero repair has become an accepted therapy to decrease the rate of ventriculoperitoneal shunting and improve neurologic function in select cases of myelomeningocele. The Management of Myelomeningocele Study (MOMS) trial excluded patients with a BMI >35 due to concerns for increased maternal complications and preterm delivery, limiting the population that may benefit from this intervention. The aim of this study was to evaluate outcomes associated with extending the maternal BMI criteria to 40 in open fetal repair of myelomeningocele. Retrospective review of fetal closure of myelomeningocele at a quaternary referral center between 2013 and 2016 with maternal BMI ranging from 35 to 40. Eleven patients with a BMI >35 were identified. The average BMI was 37. The average maternal age at the time of evaluation was 27 years. The average gestational age at fetal surgery was 24 weeks. Gestational age at birth was an average of 32 weeks. There was one perinatal death immediately following the fetal intervention. The shunt rate at 1 year was 45% (5/11 patients). In this single-institution review of expanded BMI criteria for fetal repair of myelomeningocele, we did not observe any adverse maternal outcomes associated with maternal obesity; however, the gestational age at delivery was 2 weeks earlier compared to the MOMS trial.
Sections du résumé
BACKGROUND
BACKGROUND
In utero repair has become an accepted therapy to decrease the rate of ventriculoperitoneal shunting and improve neurologic function in select cases of myelomeningocele. The Management of Myelomeningocele Study (MOMS) trial excluded patients with a BMI >35 due to concerns for increased maternal complications and preterm delivery, limiting the population that may benefit from this intervention.
OBJECTIVES
OBJECTIVE
The aim of this study was to evaluate outcomes associated with extending the maternal BMI criteria to 40 in open fetal repair of myelomeningocele.
METHOD
METHODS
Retrospective review of fetal closure of myelomeningocele at a quaternary referral center between 2013 and 2016 with maternal BMI ranging from 35 to 40.
RESULTS
RESULTS
Eleven patients with a BMI >35 were identified. The average BMI was 37. The average maternal age at the time of evaluation was 27 years. The average gestational age at fetal surgery was 24 weeks. Gestational age at birth was an average of 32 weeks. There was one perinatal death immediately following the fetal intervention. The shunt rate at 1 year was 45% (5/11 patients).
CONCLUSIONS
CONCLUSIONS
In this single-institution review of expanded BMI criteria for fetal repair of myelomeningocele, we did not observe any adverse maternal outcomes associated with maternal obesity; however, the gestational age at delivery was 2 weeks earlier compared to the MOMS trial.
Identifiants
pubmed: 31048584
pii: 000499484
doi: 10.1159/000499484
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
411-414Informations de copyright
© 2019 S. Karger AG, Basel.