Babies with myelomeningocele in Poland: parents’ attitudes on fetal surgery versus termination of pregnancy

Koszutski, Tomasz; Kawalski, Henryk; Kudela, Grzegorz; Wróblewska, Jolanta; Byrka-Owczarek, Katarzyna; Bohosiewicz, Janusz

doi:10.1007/s00381-008-0653-1

Cited by 11 publications

(7 citation statements)

References 13 publications

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“…Mothers who visit a physician regularly during pregnancy can be diagnosed earlier, and they may have the opportunity to terminate the pregnancy in the early period. However, families rarely terminate a pregnancy due to the socio-cultural characteristics of our country [24]. Although nearly three quarters of the neonates had been diagnosed with meningomyelocele during the antenatal period in our study, none of the families terminated the pregnancy.…”

Section: Discussionmentioning

confidence: 74%

Clinical Characteristics of Neonatal Meningomyelocele Cases and Effect of Operation Time on Mortality and Morbidity

Bülbül

Can²,

Bülbül³

et al. 2010

Pediatr Neurosurg

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Objective: We aimed to evaluate the clinical features, short-term prognosis, and effect of operation time on mortality and morbidity in neonates with meningomyelocele. Methods: This prospective study was conducted between January 2006 and December 2008. Clinical features, defective area, existence of additional anomalies, operation time, and morbidity and mortality data were recorded. The effectof operation time on mortality and morbidity was evaluated. Results: Patients (n = 28) were assessed during the study period. Mean birth weight, height, and head circumference were found to be 3,160 ± 582 g, 46.2 ± 3.3 cm, and 36.7 ± 4.1 cm, respectively. None of the mothers received folate supplementation. Hydrocephaly (n = 13), pes equinovarus (n = 4), pelvicalyceal ectasia (n = 4), acetabular dysplasia (n = 2), Chiari II malformation (n = 2), and hydronephrosis (n = 2) accounted for additional anomalies. The mean postnatal age for surgical operation was 3.2 ± 2.8 days; mean length of hospital stay was 10.2 ± 9.7 days. The cases operated after 72 h were hospitalized longer, received antibiotherapies for a longer duration and had higher total complication rates (p = 0.04, 0.02, and 0.01, respectively). Conclusion: Surgical operation of patients with meningomyelocele within 72 h after delivery significantly reduces not only the duration of hospitalization and antibiotic usage, but also complication rates.

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Section: Discussionmentioning

confidence: 74%

Clinical Characteristics of Neonatal Meningomyelocele Cases and Effect of Operation Time on Mortality and Morbidity

Bülbül

Can²,

Bülbül³

et al. 2010

Pediatr Neurosurg

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“…A diagnosis of MMC was made antenatally in 60% of our patients. Unfortunately, due to socio-cultural taboos regarding abortion, none of the families had consented to medical termination of pregnancy7).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Surgery Time on Prognosis in Newborns with Meningomyelocele

Öncel

Оздемир

Kahiloğulları

et al. 2012

J Korean Neurosurg Soc

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ObjectiveTo investigate the effect of surgery time on prognosis of newborns with meningomyelocele.MethodsThe records of neonates with meningomyelocele were retrospectively analyzed. Demographic and clinical characteristics as well as information, timing of surgery, and durations of hospital stay and antibiotic therapy were recorded.ResultsThe records of 30 babies were included in the final analysis. Overall, the mean gestational age was 37.7±2.7 weeks, with a mean birth weight of 2967±755 g and head circumference of 35.8±3.8 cm. In terms of localization, 46.6% of the meningomyeloceles were lumbosacral, 40% were lumbar, 10% were thoracolumbar and 3.3% were thoracal. The mean size of the meningomyelocele sacs was 4.33±1.2 cm. Newborns underwent surgery on average of 8.2±5.9 days after birth, with an overall mean duration of hospital stay of 30±25.1 days. Patients were divided into two groups based on timing of surgery (group 1, ≤5 days; group 2, >5 days), and comparisons between groups revealed that earlier surgery was associated with significantly shorter durations of hospital stay (p<0.001) and antibiotic therapy (p<0.05).ConclusionEarly surgical intervention (≤5 days) was associated with a shorter duration of hospital stay and antibiotic therapy as well as a lower complication rate. We recommend that corrective surgery be undertaken as soon as reasonably possible.

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“…However, most families rarely opt for the termination of pregnancy. 12 Although about 27.8% of patients have been diagnosed with meningomyelocele during antenatal period in our study, none of the families have opted for termination of pregnancy. In many studies, it has been found that meningomyelocoele is most commonly located in the lumbar region.…”

Section: Discussionmentioning

confidence: 64%

“…Additional anomalies which are found are hydrocephalus and Chiari II malformation. 12 In children with MMC, increased intracranial pressure and hydrocephalus occur within the first month of life. Hydrocephalus was the most common anomaly encountered in our study (50%).…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation and Management of Children with Meningomyelocoele

Shukla¹,

Chaube²

2020

jebmh

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BACKGROUND Neural tube defects (NTDs) are one of the most common birth defects affecting the Central Nervous System (CNS) and is often associated with complex birth defects compatible with survival. 1 NTD is a general term for a congenital malformation of the central nervous system (CNS) occurring secondary to lack of closure of the neural tube and has a worldwide incidence of 1.0 to 10.0 per 1,000 births. Congenital malformations of spine and spinal cord are collectively termed as spinal dysraphism. It includes a heterogenous group of anomalies resulting from incomplete midline closure of osseous, mesenchymal and nervous tissue. 2 Most of these conditions are diagnosed at or soon after birth, but some are diagnosed late in childhood or in adulthood because of absence of clinical manifestations. We wanted to evaluate the causative factors, clinical features, management and postoperative complications of children with meningomyelocoele. METHODS This is a retrospective study and all children having meningomyelocoele born between April 2014 to May 2016 were included in the study. Clinical features, maternal educational status, size and location of the defect, operative details such as time to surgery and its relation to postoperative morbidity and mortality were recorded. RESULTS A total of 36 patients were evaluated in the study period. There were 20 (55.6%) males and 16 (44.4%) females. Most common location of MMC was in lumbar (83.3%) and followed by thoracolumbar (16.7%) regions. None of the mothers received folate supplementation. Hydrocephalus (n = 18), pelvicalyceal ectasia (n = 3), pes equinovarus (n = 7), Chiari II malformation (n = 4)), pelvicalyceal ectasia (n = 3), hip dysplasias (n = 2), accounted for additional anomalies. Short term complications following surgery were bladder dysfunction in 8 patients (22.2%), 7 patients (19.4%) had seizures, 6 patients (16.7%) had bacterial meningitis and 3 patients (8.3%) had severe hydrocephalus and 4 patients (11.1%) had ventriculitis. CONCLUSIONS Operating on patients with meningomyelocoele with in 72 hrs. of birth reduces complications, hospital stay and antibiotic usage.

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Babies with myelomeningocele in Poland: parents’ attitudes on fetal surgery versus termination of pregnancy

Abstract: On the basis of these results, it was concluded that this population is potentially interested in the use of fetal surgery.

Cited by 11 publications

References 13 publications

Clinical Characteristics of Neonatal Meningomyelocele Cases and Effect of Operation Time on Mortality and Morbidity

Clinical Characteristics of Neonatal Meningomyelocele Cases and Effect of Operation Time on Mortality and Morbidity

The Effect of Surgery Time on Prognosis in Newborns with Meningomyelocele

Clinical Evaluation and Management of Children with Meningomyelocoele

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