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A study to assess global availability of fetal surgery for myelomeningocele

Sacco, A; Simpson, L; Deprest, J; David, AL; (2018) A study to assess global availability of fetal surgery for myelomeningocele. Prenatal Diagnosis , 38 (13) pp. 1020-1027. 10.1002/pd.5383. Green open access

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Abstract

AIM: To establish the provision of fetal surgery for myelomeningocele (MMC) worldwide. METHODS: Through the International Society for Prenatal Diagnosis (ISPD) Fetal Therapy Special Interest Group and the North American Fetal Therapy Network (NAFTNet), fetal therapy centres were surveyed (September 2017-June 2018) regarding availability of fetal MMC surgical repair, patient inclusion criteria, repair techniques, number of cases and outcome reporting. Responses were summarised on an interactive map on the ISPD website. RESULTS: 44 of 59 centres responded (74.6%) of which 34 centres (77.1%) currently offered fetal surgery for MMC and 7 centres (15.9%) were awaiting a first case after service set up. Patient inclusion criteria were similar and based on the Management of Myelomeningocele (MOMS) trial. Five centres (14.7%) operated beyond 26 weeks' gestational age, outside the MOMS criteria. Open fetal surgery was provided in 23 centres (67.6%), fetoscopic surgery only in five (14.7%), and six centres offered both types (17.6%). Neurosurgical closure was similar for open surgery but highly variable in fetoscopy surgery. The median number of cases per centre was 21 (range 1-253). CONCLUSIONS: Fetal surgery for MMC is now offered globally. Two thirds of centres offer open repair via hysterotomy using criteria based on the MOMS trial.

Type: Article
Title: A study to assess global availability of fetal surgery for myelomeningocele
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/pd.5383
Publisher version: https://doi.org/10.1002/pd.5383
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Spina bifida, myelomeningocele, fetal surgery, open fetal surgery, fetoscopy, fetal surgery centre
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Maternal and Fetal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10061173
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