Fetal surgical intervention for myelomeningocele: lessons learned, outcomes, and future implications.
Journal
Developmental medicine and child neurology
ISSN: 1469-8749
Titre abrégé: Dev Med Child Neurol
Pays: England
ID NLM: 0006761
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
accepted:
28
10
2019
pubmed:
17
12
2019
medline:
7
7
2020
entrez:
17
12
2019
Statut:
ppublish
Résumé
Fetal myelomeningocele (fMMC) closure (spina bifida aperta) has become a care option for patients that meet inclusion criteria, but it is clear that fetal intervention, while improving outcomes, is not a cure. This review will: (1) focus on the rationale for fMMC surgery based on preclinical studies and observations that laid the foundation for human pilot studies and a randomized controlled trial; (2) summarize important clinical outcomes; (3) discuss the feasibility, efficacy, and safety of recent developments in fetal surgical techniques and approaches; and (4) highlight future research directions. Given the increased risk of maternal and fetal morbidity associated with prenatal intervention, accompanied by the increasing number of centres performing interventions worldwide, teams involved in the care of these patients need to proceed with caution to maintain technical expertise, competency, and patient safety. Ongoing assessment of durability of the benefits of fMMC surgery, as well as additional refinement of patient selection criteria and counselling, is needed to further improve outcomes and reduce the risks to the mother and fetus. WHAT THIS PAPER ADDS: High-quality prospective studies are needed to broaden the indication for fetal surgery in the general myelomeningocele population. Innovative minimally invasive approaches have had promising results, yet lack comprehensive and robust experimental or clinical evaluation. Important information to help families make informed decisions regarding fetal surgery for myelomeningocele is provided. INTERVENCIÓN QUIRÚRGICA FETAL PARA MIELOMENINGOCELE: LECCIONES APRENDIDAS, RESULTADOS E IMPLICACIONES FUTURAS: El cierre del mielomeningocele fetal (fMMC) (espina bífida) se ha convertido en una opción de atención para pacientes que cumplen con los criterios de inclusión, pero está claro que la intervención fetal mientras se mejoran los resultados no es una cura. Esta revisión: (1) se centrará en la justificación de la cirugía fMMC basada en estudios preclínicos y observaciones que sentaron las bases para estudios piloto humanos y un ensayo controlado aleatorio; (2) resumir resultados clínicos importantes; (3) discutir la viabilidad, eficacia y seguridad de los desarrollos recientes en técnicas y enfoques de cirugía fetal; y (4) resaltar futuras direcciones de investigación. Dado el mayor riesgo de morbilidad materna y fetal asociada con la intervención prenatal, acompañado por el creciente número de centros que realizan intervenciones en todo el mundo, los equipos involucrados en la atención de estos pacientes deben proceder con precaución para mantener la experiencia técnica, la competencia y la seguridad del paciente. Se necesita una evaluación continua de la durabilidad de los beneficios de la cirugía fMMC, así como un refinamiento adicional de los criterios de selección de pacientes y asesoramiento, para mejorar aún más los resultados y reducir los riesgos para la madre y el feto. INTERVENÇÃO CIRÚRGICA FETAL PARA MIELOMENINGOCELE: LIÇÕES APRENDIDAS, RESULTADOS E IMPLICAÇÕES FUTURAS: O fechamento fetal da mielomeningocele (fFMM), ou espinha bífida aberta, se tornou uma opção de cuidado para pacientes que atendem aos critérios de inclusão, mas está claro que, embora melhore os resultados, a intervenção fetal não representa cura. Esta revisão irá: 1) focar nos princípios da cirurgia de fFMM com base em estudos pré-clínicos e observações que basearam estudos pilotos com humanos e um estudo randomizado controlado; 2) sintetizar resultados clínicos importantes; 3) discutir a viabilidade, eficácia e segurança dos desenvolvimentos recentes em técnicas e abordagens de cirurgia fetal; e 4) destacar direções para futuras pesquisas. Dado o risco aumentado de morbidade maternal e fetal associado com a intervenção pré-natal, acompanhado pelo aumento no número de centros que realizam a intervenção no mundo, equipes envolvidas no cuidado destes pacientes precisam proceder com cautela para manter a especialidade técnica, competência e segurança dos pacientes. Contínua avaliação da durabilidade dos benefícios da fFMMM, assim como refinamento adicional dos critérios de seleção de pacientes e aconselhamento, são necessários para melhorar os resultados e reduzir os riscos para mãe e feto.
Autres résumés
Type: Publisher
(spa)
INTERVENCIÓN QUIRÚRGICA FETAL PARA MIELOMENINGOCELE: LECCIONES APRENDIDAS, RESULTADOS E IMPLICACIONES FUTURAS: El cierre del mielomeningocele fetal (fMMC) (espina bífida) se ha convertido en una opción de atención para pacientes que cumplen con los criterios de inclusión, pero está claro que la intervención fetal mientras se mejoran los resultados no es una cura. Esta revisión: (1) se centrará en la justificación de la cirugía fMMC basada en estudios preclínicos y observaciones que sentaron las bases para estudios piloto humanos y un ensayo controlado aleatorio; (2) resumir resultados clínicos importantes; (3) discutir la viabilidad, eficacia y seguridad de los desarrollos recientes en técnicas y enfoques de cirugía fetal; y (4) resaltar futuras direcciones de investigación. Dado el mayor riesgo de morbilidad materna y fetal asociada con la intervención prenatal, acompañado por el creciente número de centros que realizan intervenciones en todo el mundo, los equipos involucrados en la atención de estos pacientes deben proceder con precaución para mantener la experiencia técnica, la competencia y la seguridad del paciente. Se necesita una evaluación continua de la durabilidad de los beneficios de la cirugía fMMC, así como un refinamiento adicional de los criterios de selección de pacientes y asesoramiento, para mejorar aún más los resultados y reducir los riesgos para la madre y el feto.
Type: Publisher
(por)
INTERVENÇÃO CIRÚRGICA FETAL PARA MIELOMENINGOCELE: LIÇÕES APRENDIDAS, RESULTADOS E IMPLICAÇÕES FUTURAS: O fechamento fetal da mielomeningocele (fFMM), ou espinha bífida aberta, se tornou uma opção de cuidado para pacientes que atendem aos critérios de inclusão, mas está claro que, embora melhore os resultados, a intervenção fetal não representa cura. Esta revisão irá: 1) focar nos princípios da cirurgia de fFMM com base em estudos pré-clínicos e observações que basearam estudos pilotos com humanos e um estudo randomizado controlado; 2) sintetizar resultados clínicos importantes; 3) discutir a viabilidade, eficácia e segurança dos desenvolvimentos recentes em técnicas e abordagens de cirurgia fetal; e 4) destacar direções para futuras pesquisas. Dado o risco aumentado de morbidade maternal e fetal associado com a intervenção pré-natal, acompanhado pelo aumento no número de centros que realizam a intervenção no mundo, equipes envolvidas no cuidado destes pacientes precisam proceder com cautela para manter a especialidade técnica, competência e segurança dos pacientes. Contínua avaliação da durabilidade dos benefícios da fFMMM, assim como refinamento adicional dos critérios de seleção de pacientes e aconselhamento, são necessários para melhorar os resultados e reduzir os riscos para mãe e feto.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
417-425Informations de copyright
© 2019 Mac Keith Press.
Références
Danzer E, Johnson MP, Adzick NS. Fetal surgery for myelomeningocele: progress and perspectives. Dev Med Child Neurol 2012; 54: 8-14.
Mitchell LE, Adzick NS, Melchionne J, Pasquariello PS, Sutton LN, Whitehead AS. Spina bifida. Lancet 2004; 364: 1885-95.
Parker SE, Mai CT, Canfield MA, et al. Updated National Birth Prevalence estimates for selected birth defects in the United States, 2004-2006. Birth Defects Res A Clin Mol Teratol 2010; 88: 1008-16.
Canfield MA, Mai CT, Wang Y, et al. The association between race/ethnicity and major birth defects in the United States, 1999-2007. Am J Public Health 2014; 104: e14-23.
Khoshnood B, Loane M, de Walle H, et al. Long term trends in prevalence of neural tube defects in Europe: population based study. BMJ 2015; 351: h5949.
De Wals P, Tairou F, Van Allen MI, et al. Reduction in neural-tube defects after folic acid fortification in Canada. N Engl J Med 2007; 357: 135-42.
Waitzman NJ, Romano PS, Scheffler RM. Estimates of the economic costs of birth defects. Inquiry 1994; 31: 188-205.
Oakeshott P, Hunt GM, Poulton A, Reid F. Expectation of life and unexpected death in open spina bifida: a 40-year complete, non-selective, longitudinal cohort study. Dev Med Child Neurol 2010; 52: 749-53.
Adzick NS, Thom EA, Spong CY, et al. A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med 2011; 364: 993-1004.
Heffez DS, Aryanpur J, Hutchins GM, Freeman JM. The paralysis associated with myelomeningocele: clinical and experimental data implicating a preventable spinal cord injury. Neurosurgery 1990; 26: 987-92.
Osaka K, Tanimura T, Hirayama A, Matsumoto S. Myelomeningocele before birth. J Neurosurg 1978; 49: 711-24.
Meuli M, Meuli-Simmen C, Hutchins GM, Seller MJ, Harrison MR, Adzick NS. The spinal cord lesion in human fetuses with myelomeningocele: implications for fetal surgery. J Pediatr Surg 1997; 32: 448-52.
Kowitzke B, Cohrs G, Leuschner I, et al. Cellular profiles and molecular mediators of lesion cascades in the placode in human open spinal neural tube defects. J Neuropathol Exp Neurol 2016; 75: 827-42.
Danzer E, Ernst LM, Rintoul NE, Johnson MP, Adzick NS, Flake AW. In utero meconium passage in fetuses and newborns with myelomeningocele. J Neurosurg Pediatr 2009; 3: 141-6.
Sival DA, Guerra M, den Dunnen WF, et al. Neuroependymal denudation is in progress in full-term human foetal spina bifida aperta. Brain Pathol 2011; 21: 163-79.
Sival DA, Verbeek RJ, Brouwer OF, Sollie KM, Bos AF, den Dunnen WF. Spinal hemorrhages are associated with early neonatal motor function loss in human spina bifida aperta. Early Hum Dev 2008; 84: 423-31.
Korenromp MJ, van Gool JD, Bruinese HW, Kriek R. Early fetal leg movements in myelomeningocele. Lancet 1986; 1: 917-8.
Sival DA, Begeer JH, Staal-Schreinemachers AL, Vos-Niel JM, Beekhuis JR, Prechtl HF. Perinatal motor behaviour and neurological outcome in spina bifida aperta. Early Hum Dev 1997; 50: 27-37.
Verbeek RJ, van der Hoeven JH, Maurits NM, Brouwer OF, Hoving EW, Sival DA. In spina bifida aperta, muscle ultrasound can quantify the "second hit of damage". Childs Nerv Syst 2013; 29: 469-74.
Verbeek RJ, van der Hoeven JH, Sollie KM, et al. Muscle ultrasound density in human fetuses with spina bifida aperta. Early Hum Dev 2009; 85: 519-23.
Duckworth T, Sharrard WJ, Lister J, Seymour N. Hemimyelocele. Dev Med Child Neurol 1968; Suppl 16: 69+.
Michejda M. Intrauterine treatment of spina bifida: primate model. Z Kinderchir 1984; 39: 259-61.
Heffez DS, Aryanpur J, Rotellini NA, Hutchins GM, Freeman JM. Intrauterine repair of experimental surgically created dysraphism. Neurosurgery 1993; 32: 1005-10.
Meuli M, Meuli-Simmen C, Yingling CD, et al. Creation of myelomeningocele in utero: a model of functional damage from spinal cord exposure in fetal sheep. J Pediatr Surg 1995; 30: 1028-32.
Housley HT, Graf JL, Lipshultz GS, et al. Creation of myelomeningocele in the fetal rabbit. Fetal Diagn Ther 2000; 15: 275-9.
Meuli M, Meuli-Simmen C, Yingling CD, et al. In utero repair of experimental myelomeningocele saves neurological function at birth. J Pediatr Surg 1996; 31: 397-402.
Meuli M, Meuli-Simmen C, Hutchins GM, et al. In utero surgery rescues neurological function at birth in sheep with spina bifida. Nat Med 1995; 1: 342-7.
Paek BW, Farmer DL, Wilkinson CC, et al. Hindbrain herniation develops in surgically created myelomeningocele but is absent after repair in fetal lambs. Am J Obstet Gynecol 2000; 183: 1119-23.
Bouchard S, Davey MG, Rintoul NE, Walsh DS, Rorke LB, Adzick NS. Correction of hindbrain herniation and anatomy of the vermis after in utero repair of myelomeningocele in sheep. J Pediatr Surg 2003; 38: 451-8.
Encinas JL, Garcia-Cabezas MA, Barkovich J, et al. Maldevelopment of the cerebral cortex in the surgically induced model of myelomeningocele: implications for fetal neurosurgery. J Pediatr Surg 2011; 46: 713-22.
Joyeux L, Engels AC, Van Der Merwe J, et al. Validation of the fetal lamb model of spina bifida. Sci Rep 2019; 9: 9327.
Danzer E, Schwarz U, Wehrli S, Radu A, Adzick NS, Flake AW. Retinoic acid induced myelomeningocele in fetal rats: characterization by histopathological analysis and magnetic resonance imaging. Exp Neurol 2005; 194: 467-75.
Danzer E, Kiddoo DA, Redden RA, et al. Structural and functional characterization of bladder smooth muscle in fetal rats with retinoic acid-induced myelomeningocele. Am J Physiol Renal Physiol 2007; 292: F197-206.
Danzer E, Radu A, Robinson LE, Volpe MV, Adzick NS, Flake AW. Morphologic analysis of the neuromuscular development of the anorectal unit in fetal rats with retinoic acid induced myelomeningocele. Neurosci Lett 2008; 430: 157-62.
Danzer E, Zhang L, Radu A, et al. Amniotic fluid levels of glial fibrillary acidic protein in fetal rats with retinoic acid induced myelomeningocele: a potential marker for spinal cord injury. Am J Obstet Gynecol 2011; 204: 178.
Watanabe M, Kim AG, Flake AW. Tissue engineering strategies for fetal myelomeningocele repair in animal models. Fetal Diagn Ther 2015; 37: 197-205.
Danzer E, Adzick NS. Fetal surgery for myelomeningocele: patient selection, perioperative management and outcomes. Fetal Diagn Ther 2011; 30: 163-73.
Heuer GG, Adzick NS, Sutton LN. Fetal myelomeningocele closure: technical considerations. Fetal Diagn Ther 2015; 37: 166-71.
Rychik J, Tian Z, Cohen MS, et al. Acute cardiovascular effects of fetal surgery in the human. Circulation 2004; 110: 1549-56.
Bruner JP, Tulipan NE, Richards WO. Endoscopic coverage of fetal open myelomeningocele in utero. Am J Obstet Gynecol 1997; 176: 256-7.
Adzick NS, Sutton LN, Crombleholme TM, Flake AW. Successful fetal surgery for spina bifida. Lancet 1998; 352: 1675-6.
Sutton LN, Adzick NS, Bilaniuk LT, Johnson MP, Crombleholme TM, Flake AW. Improvement in hindbrain herniation demonstrated by serial fetal magnetic resonance imaging following fetal surgery for myelomeningocele. JAMA 1999; 282: 1826-31.
Bruner JP, Tulipan N, Paschall RL, et al. Fetal surgery for myelomeningocele and the incidence of shunt-dependent hydrocephalus. JAMA 1999; 282: 1819-25.
Tulipan N, Hernanz-Schulman M, Bruner JP. Reduced hindbrain herniation after intrauterine myelomeningocele repair: a report of four cases. Pediatr Neurosurg 1998; 29: 274-8.
Tulipan N, Sutton LN, Bruner JP, Cohen BM, Johnson M, Adzick NS. The effect of intrauterine myelomeningocele repair on the incidence of shunt-dependent hydrocephalus. Pediatr Neurosurg 2003; 38: 27-33.
Danzer E, Johnson MP, Bebbington M, et al. Fetal head biometry assessed by fetal magnetic resonance imaging following in utero myelomeningocele repair. Fetal Diagn Ther 2007; 22: 1-6.
Danzer E, Johnson MP, Wilson RD, et al. Fetal head biometry following in-utero repair of myelomeningocele. Ultrasound Obstet Gynecol 2004; 24: 606-11.
Tulipan N, Bruner JP, Hernanz-Schulman M, et al. Effect of intrauterine myelomeningocele repair on central nervous system structure and function. Pediatr Neurosurg 1999; 31: 183-8.
Danzer E, Finkel R, Gerdes M, et al. The relationship of seizure activity and chronic epilepsy in early infancy and short-term neurodevelopmental outcome following fetal myelomeningocele closure. Neuropediatrics 2010; 41: 140-3.
Danzer E, Finkel RS, Rintoul NE, et al. Reversal of hindbrain herniation after maternal-fetal surgery for myelomeningocele subsequently impacts on brain stem function. Neuropediatrics 2008; 39: 359-62.
Johnson MP, Sutton LN, Rintoul N, et al. Fetal myelomeningocele repair: short-term clinical outcomes. Am J Obstet Gynecol 2003; 189: 482-7.
Rintoul NE, Sutton LN, Hubbard AM, et al. A new look at myelomeningoceles: functional level, vertebral level, shunting, and the implications for fetal intervention. Pediatrics 2002; 109: 409-13.
Farmer DL, von Koch CS, Peacock WJ, et al. In utero repair of myelomeningocele: experimental pathophysiology, initial clinical experience, and outcomes. Arch Surg 2003; 138: 872-8.
Danzer E, Gerdes M, Bebbington MW, et al. Lower extremity neuromotor function and short-term ambulatory potential following in utero myelomeningocele surgery. Fetal Diagn Ther 2009; 25: 47-53.
Danzer E, Gerdes M, Bebbington MW, Zarnow DM, Adzick NS, Johnson MP. Preschool neurodevelopmental outcome of children following fetal myelomeningocele closure. Am J Obstet Gynecol 2010; 202: 450.
Danzer E, Thomas NH, Thomas A, et al. Long-term neurofunctional outcome, executive functioning, and behavioral adaptive skills following fetal myelomeningocele surgery. Am J Obstet Gynecol 2016; 214: 269.
Danzer E, Adzick NS, Rintoul NE, et al. Intradural inclusion cysts following in utero closure of myelomeningocele: clinical implications and follow-up findings. J Neurosurg Pediatr 2008; 2: 406-13.
Tulipan N, Wellons JC 3rd, Thom EA, et al. Prenatal surgery for myelomeningocele and the need for cerebrospinal fluid shunt placement. J Neurosurg Pediatr 2015; 16: 613-20.
Farmer DL, Thom EA, Brock JW 3rd, et al. The Management of Myelomeningocele Study: full cohort 30-month pediatric outcomes. Am J Obstet Gynecol 2018; 218: 256.
Houtrow AJ, Burrows PK, Thom EA. Comparing neurodevelopmental outcomes at 30 months by presence of hydrocephalus and shunt status among children enrolled in the MOMS trial. J Pediatr Rehabil Med 2018; 11: 227-35.
Brock JW 3rd, Carr MC, Adzick NS, et al. Bladder function after fetal surgery for myelomeningocele. Pediatrics 2015; 136: e906-13.
Brock JW 3rd, Thomas JC, Baskin LS, et al. Effect of prenatal repair of myelomeningocele on urological outcomes at school age. J Urol 2019; 202: 812-8. Doi: https://doi.org/10.1097/JU0000000000000334. [E-pub ahead of print].
Johnson MP, Bennett KA, Rand L, et al. The Management of Myelomeningocele Study: obstetrical outcomes and risk factors for obstetrical complications following prenatal surgery. Am J Obstet Gynecol 2016; 215: 778.
Adzick NS, Harrison MR. Fetal surgical therapy. Lancet 1994; 343: 897-902.
Danzer E, Sydorak RM, Harrison MR, Albanese CT. Minimal access fetal surgery. Eur J Obstet Gynecol Reprod Biol 2003; 108: 3-13.
Deprest JA, Evrard VA, Van Schoubroeck D, Vandenberghe K. Endoscopic cord ligation in selective feticide. Lancet 1996; 348: 890-1.
Wilson RD, Johnson MP, Crombleholme TM, et al. Chorioamniotic membrane separation following open fetal surgery: pregnancy outcome. Fetal Diagn Ther 2003; 18: 314-20.
Soni S, Moldenhauer JS, Spinner SS, et al. Chorioamniotic membrane separation and preterm premature rupture of membranes complicating in utero myelomeningocele repair. Am J Obstet Gynecol 2016; 214: 647.
Goodnight WH, Bahtiyar O, Bennett KA, et al. Subsequent pregnancy outcomes after open maternal-fetal surgery for myelomeningocele. Am J Obstet Gynecol 2019; 220: 494.
Antiel RM, Adzick NS, Thom EA, et al. Impact on family and parental stress of prenatal vs postnatal repair of myelomeningocele. Am J Obstet Gynecol 2016; 215: 522.
Bennett KA, Carroll MA, Shannon CN, et al. Reducing perinatal complications and preterm delivery for patients undergoing in utero closure of fetal myelomeningocele: further modifications to the multidisciplinary surgical technique. J Neurosurg Pediatr 2014; 14: 108-14.
Moldenhauer JS, Soni S, Rintoul NE, et al. Fetal myelomeningocele repair: the post-MOMS experience at the Children's Hospital of Philadelphia. Fetal Diagn Ther 2015; 37: 235-40.
Zaretsky MV, Liechty KW, Galan HL, et al. Modified hysterotomy closure technique for open fetal surgery. Fetal Diagn Ther 2018; 44: 105-11.
Elbabaa SK, Gildehaus AM, Pierson MJ, Albers JA, Vlastos EJ. First 60 fetal in-utero myelomeningocele repairs at Saint Louis Fetal Care Institute in the post-MOMS trial era: hydrocephalus treatment outcomes (endoscopic third ventriculostomy versus ventriculo-peritoneal shunt). Childs Nervous Syst 2017; 33: 1157-68.
Moron AF, Barbosa MM, Milani H, et al. Perinatal outcomes after open fetal surgery for myelomeningocele repair: a retrospective cohort study. BJOG 2018; 125: 1280-6.
Zamlynski J, Olejek A, Koszutski T, et al. Comparison of prenatal and postnatal treatments of spina bifida in Poland - a non-randomized, single-center study. J Matern Fetal Neonatal Med 2014; 27: 1409-17.
Joyeux L, De Bie F, Danzer E, et al. Learning curves of open and endoscopic fetal spina bifida closure: a systematic review and meta-analysis. Ultrasound Obstet Gynecol 2019. Doi: https://doi.org/10.1002/uog.20389. [E-pub ahead of print].
AlRefai A, Drake J, Kulkarni AV, et al. Fetal myelomeningocele surgery: only treating the tip of the iceberg. Prenat Diagn 2019; 39: 10-5.
Moise KJ Jr, Moldenhauer JS, Bennett KA, et al. Current selection criteria and perioperative therapy used for fetal myelomeningocele surgery. Obstet Gynecol 2016; 127: 593-7.
Deputy NP, Dub B, Sharma AJ. Prevalence and trends in prepregnancy normal weight - 48 states, New York City, and District of Columbia, 2011-2015. MMWR Morb Mortal Wkly Rep 2018; 66: 1402-7.
McMahon DM, Liu J, Zhang H, Torres ME, Best RG. Maternal obesity, folate intake, and neural tube defects in offspring. Birth Defects Res A Clin Mol Teratol 2013; 97: 115-22.
Hilton SA, Hodges MM, Dewberry LC, et al. MOMS Plus: single-institution review of outcomes for extended bmi criteria for open fetal repair of myelomeningocele. Fetal Diagn Ther 2019. Doi: https://doi.org/10.1159/000499484. [E-pub ahead of print].
Belfort MA, Whitehead WE, Shamshirsaz AA, Ruano R, Cass DL, Olutoye OO. Fetoscopic repair of meningomyelocele. Obstet Gynecol 2015; 126: 881-4.
Belfort MA, Whitehead WE, Shamshirsaz AA, et al. Fetoscopic open neural tube defect repair: development and refinement of a two-port, carbon dioxide insufflation technique. Obstet Gynecol 2017; 129: 734-43.
Kohl T. Percutaneous minimally invasive fetoscopic surgery for spina bifida aperta. Part I: surgical technique and perioperative outcome. Ultrasound Obstet Gynecol 2014; 44: 515-24.
Degenhardt J, Schurg R, Winarno A, et al. Percutaneous minimal-access fetoscopic surgery for spina bifida aperta. Part II: maternal management and outcome. Ultrasound Obstet Gynecol 2014; 44: 525-31.
Lapa Pedreira DA, Acacio GL, Goncalves RT, et al. Percutaneous fetoscopic closure of large open spina bifida using a bilaminar skin substitute. Ultrasound Obstet Gynecol 2018; 52: 458-66.
Pedreira DA, Zanon N, Nishikuni K, et al. Endoscopic surgery for the antenatal treatment of myelomeningocele: the CECAM trial. Am J Obstet Gynecol 2016; 214: 111.
Flake A. Percutaneous minimal-access fetoscopic surgery for myelomeningocele - not so minimal!. Ultrasound Obstet Gynecol 2014; 44: 499-500.
Belfort M, Deprest J, Hecher K. Current controversies in prenatal diagnosis 1: in utero therapy for spina bifida is ready for endoscopic repair. Prenatal Diagn 2016; 36: 1161-6.
Cohen AR, Couto J, Cummings JJ, et al. Position statement on fetal myelomeningocele repair. Am J Obstet Gynecol 2014; 210: 107-11.
Tarui T, Kim A, Flake A, et al. Amniotic fluid transcriptomics reflects novel disease mechanisms in fetuses with myelomeningocele. Am J Obstet Gynecol 2017; 217: 587.
Kim AG, Danzer E, Moldenhauer JS, et al. Amniotic fluid concentrations of glial fibrillary acidic protein do not correlate with prenatal metrics in fetuses with myelomeningocele. Fetal Diagn Ther 2018; 43: 297-303.
McCulloch P, Altman DG, Campbell WB, et al. No surgical innovation without evaluation: the IDEAL recommendations. Lancet 2009; 374: 1105-12.
Hirst A, Philippou Y, Blazeby J, et al. No surgical innovation without evaluation: evolution and further development of the IDEAL framework and recommendations. Ann Surg 2019; 269: 211-20.
Shieh HF, Ahmed A, Rohrer L, Zurakowski D, Fauza DO. Donor mesenchymal stem cell linetics after transamniotic stem cell therapy (TRASCET) for experimental spina bifida. J Pediatr Surg 2018; 53: 1134-6.
Dionigi B, Brazzo JA 3rd, Ahmed A, et al. Trans-amniotic stem cell therapy (TRASCET) minimizes Chiari-II malformation in experimental spina bifida. J Pediatr Surg 2015; 50: 1037-41.
Brown EG, Keller BA, Lankford L, et al. Age does matter: a pilot comparison of placenta-derived stromal cells for in utero repair of myelomeningocele using a lamb model. Fetal Diagn Ther 2016; 39: 179-85.
Wang A, Brown EG, Lankford L, et al. Placental mesenchymal stromal cells rescue ambulation in ovine myelomeningocele. Stem Cells Transl Med 2015; 4: 659-69.
Brown EG, Saadai P, Pivetti CD, et al. In utero repair of myelomeningocele with autologous amniotic membrane in the fetal lamb model. J Pediatr Surg 2014; 49: 133-7.
Watanabe M, Li H, Kim AG, et al. Complete tissue coverage achieved by scaffold-based tissue engineering in the fetal sheep model of myelomeningocele. Biomaterials 2016; 76: 133-43.
Watanabe M, Li H, Roybal J, et al. A tissue engineering approach for prenatal closure of myelomeningocele: comparison of gelatin sponge and microsphere scaffolds and bioactive protein coatings. Tissue Eng Part A 2011; 17: 1099-110.
Watanabe M, Jo J, Radu A, Kaneko M, Tabata Y, Flake AW. A tissue engineering approach for prenatal closure of myelomeningocele with gelatin sponges incorporating basic fibroblast growth factor. Tissue Eng Part A 2010; 16: 1645-55.
Joyeux L, De Bie F, Danzer E, Van Mieghem T, Flake AW, Deprest J. Safety and efficacy of fetal surgery techniques to close a spina bifida defect in the fetal lamb model: a systematic review. Prenatal Diagn 2018; 38: 231-42.
Inversetti A, Van der Veeken L, Thompson D, et al. Neurodevelopmental outcome of children with spina bifida aperta repaired prenatally vs postnatally: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2019; 53: 293-301.
Riley JS, Antiel RM, Flake AW, et al. Pediatric neurosurgeons' views regarding prenatal surgery for myelomeningocele and the management of hydrocephalus: a national survey. Neurosurg Focus 2019; 47: E8.
Antiel RM, Flake AW, Collura CA, et al. Weighing the social and ethical considerations of maternal-fetal surgery. Pediatrics 2017; 140: e20170608.
Van Calenbergh F, Joyeux L, Deprest J. Maternal-fetal surgery for myelomeningocele: some thoughts on ethical, legal, and psychological issues in a Western European situation. Childs Nerv Syst 2017; 33: 1247-52.
Zamlyniski J, Olejek A, Bohosiewicz J, et al. Perinatal results of intrauterine open fetal surgery of fetuses diagnosed with myelomeningocoele - the clinical report of ten cases. Ginekol Pol 2007; 78: 647-51.
Hisaba WJ, Cavalheiro S, Almodim CG, et al. Intrauterine myelomeningocele repair postnatal results and follow-up at 3.5 years of age - initial experience from a single reference service in Brazil. Childs Nerv Syst 2012; 28: 461-7.