Comparison of prenatal and postnatal treatments of spina bifida in Poland – a non-randomized, single-center study

Zamłyński, Jacek; Olejek, Anita; Koszutski, Tomasz; Ziomek, Gabriela; Horzelska, Ewa; Gajewska-Kucharek, Alicja; Maruniak‐Chudek, Iwona; Herman‐Sucharska, Izabela; Kluczewska, Ewa; Horák, Stanisław; Bodzek, Piotr; Zamłyński, Mateusz; Kowalik, Joanna; Horzelski, Tomasz; Bohosiewicz, Janusz

doi:10.3109/14767058.2013.858689

Cited by 63 publications

(87 citation statements)

References 23 publications

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“…The patients reported on by Graf et al [26], Pedreira et al [27], Degenhardt et al [28], Verbeek et al [29], and Belfort et al [24] underwent fetoscopic repair of MMC. The patients reported on by Danzer et al [30], Friszer et al [31], Moldenhauer et al [32], Zamłyński et al [33], Bennett et al [34], and Hisaba et al [35] underwent open fetal repair of MMC. For each of the 11 studies, the data The patients reported on by Degenhart et al [28] overlap with those reported on by Kohl [12] in 2014, and the patients reported on by Verbeek et al [29] overlap with those reported on by Kohl et al [11] in 2010.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Incomplete outcome data were reported by Moldenhauer et al [32] and Zamłyński et al [33]. Of the 101 patients who were taken to the operating room for open fetal repair of MMC in the study by Moldenhauer et al [32], 2 patients were excluded from analysis of the outcomes as these 2 pregnancies were still ongoing.…”

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

“…Moldenhauer et al [32] reported the delivery and neonatal outcomes of only those patients delivered at the Children's Hospital of Philadelphia. Zamłyński et al [33] reported the rate of VPS placement based on a sample size of only 18 and the rate of reversal of hindbrain herniation based on a sample size of 28 out of an overall study population including 46 patients. Selective reporting of obstetrical or postnatal outcomes was common.…”

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

“…2 Proportion of better motor response relative to MMC level. Zamłyński et al [33] and Danzer et al [30] reported functional outcomes such as ambulation but did not specify the precise proportion of patients who had a better motor response relative to the lesion level. 3 Table 5).…”

Section: Homogeneity Testmentioning

confidence: 99%

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Fetal Surgery for Myelomeningocele: A Systematic Review and Meta-Analysis of Outcomes in Fetoscopic versus Open Repair

et al. 2017

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Background/Objectives: The Management of Myelomeningocele (MMC) Study (MOMS) showed that prenatal repair of MMC resulted in improved neurological outcomes but was associated with high rates of obstetrical complications. This study compares outcomes of open and fetoscopic MMC repair. Data Sources: PubMed and Embase studies reporting outcomes of fetal MMC repair published since the completion of the MOMS. Results: We analyzed 11 studies and found no difference in mortality or the rate of shunt placement for hydrocephalus. Percutaneous fetoscopic repair was associated with higher rates of premature rupture of membranes (91 vs. 36%, p < 0.01) and preterm birth (96 vs. 81%, p = 0.04) compared to open repair, whereas fetoscopic repair via maternal laparotomy reduced preterm birth. The rate of dehiscence and leakage from the MMC repair site was higher after both types of fetoscopic surgery (30 vs. 7%, p < 0.01), while the rate of uterine dehiscence was higher after open repair (11 vs. 0%, p < 0.01). Discussion: Fetoscopic repair is a promising alternative to open fetal MMC repair with a lower risk of uterine dehiscence; however, fetoscopic techniques should be optimized to overcome the high rate of dehiscence and leakage at the MMC repair site. A fetoscopic approach via maternal laparotomy reduces the risk of preterm birth.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

Section: Homogeneity Testmentioning

confidence: 99%

See 2 more Smart Citations

Fetal Surgery for Myelomeningocele: A Systematic Review and Meta-Analysis of Outcomes in Fetoscopic versus Open Repair

et al. 2017

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“…In the next report, concerning 31 IUMR cases, control fetal MRI revealed that 13 out of 19 fetuses demonstrated HH reduction and no progression was noticed in 6 cases [26]. In our non-randomized study, we compared a group of 46 fetuses treated in utero to 47 patients with MMC postnatal closure [28]. In this observation up to 53 months of life, decreased VPS implantation rate the first group (27.8% vs. 80%; CI 0.35, 0.16-0.75; p < 0.008), lower HH (11% vs. 70%; CI 0.16, 0.04-0.06, p < 0.01), and better motor function were noticed in the first group.…”

Section: Fmmc Repair -Polish Clinical Experiencementioning

confidence: 99%

Current views on fetal surgical treatment of myelomeningocele — the Management of Myelomeningocele Study (MOMS) trial and Polish clinical experience

Zamłyński¹,

Horzelska²,

Zamłyński³

et al. 2017

Ginekol Pol

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Myelomeningocele (MMC) constitutes the most common congenital defect of the central nervous system, with no satisfactory alternative to the postnatal treatment. Prenatal repair of MMC is aimed at protecting from a Chiari type II malformation. The main goal of fetal MMC repair is to improve the development and quality of life in children with a Chiari type II malformation. The Management of Myelomeningocele Study (MOMS), which was published in 2011, confirmed the effectiveness of prenatal surgery. In this paper, we compared the MOMS results with our own clinical experience. Owing to high effectiveness and significant improvement in the safety of the maternal-fetal surgery, prenatal MMC repair has become a new standard of treatment.

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Prenatal myelomeningocele repair improves urinary continence and reduces the risk of constipation

Pastuszka

Bohosiewicz

Koszutski

2018

Neurourology and Urodynamics

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Prenatal MMC repair ensures statistically significant improvement of the degree of social urinary continence, reducing the risk of urinary infections and constipation. Time of MMC repair does not statistically influence the urodynamic tests results and the urodynamic parameters are not the prognostic elements to assess the social urinary continence possibility in patients with the neurogenic bladder.

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Comparison of prenatal and postnatal treatments of spina bifida in Poland – a non-randomized, single-center study

Abstract: Prenatal MMC closure significantly lowers further adverse evolution of the II CM. Further studies are needed, especially on preventive measures for preterm labor and iatrogenic preterm prelabor rupture of membranes (iPPRM) in the postoperative course of IUMR.

Cited by 63 publications

References 23 publications

Fetal Surgery for Myelomeningocele: A Systematic Review and Meta-Analysis of Outcomes in Fetoscopic versus Open Repair

Fetal Surgery for Myelomeningocele: A Systematic Review and Meta-Analysis of Outcomes in Fetoscopic versus Open Repair

Current views on fetal surgical treatment of myelomeningocele — the Management of Myelomeningocele Study (MOMS) trial and Polish clinical experience

Prenatal myelomeningocele repair improves urinary continence and reduces the risk of constipation

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