Fetal-Maternal Surgery for Spina Bifida in a HIV-Infected Mother

Elrod, Julia; Ochsenbein‐Kölble, Nicole; Mazzone, Luca; Zimmermann, Roland; Berger, Christoph; Speck, Roberto F.; Strübing, Nele; Mohr, C; Moehrlen, Ueli; Meuli, Martin

doi:10.1159/000521788

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…HIV is commonly used as an exclusion criterion in studies on fetal treatment. Elrod J ( 63 ) attempted to repair fetal spina bifida in a pregnant woman with HIV infection, and the fetus was confirmed to be free of HIV infection after birth. This case report also brought some inspiration to fetal treatment.…”

Section: Discussionmentioning

confidence: 99%

Trends in research related to fetal therapy from 2012 to 2022: a bibliometric analysis

Jia,

Liang,

Liu

et al. 2024

Front. Pediatr.

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BackgroundThe development of prenatal diagnosis technology allows prompt detection of severe fetal diseases. To address adverse factors that threaten fetal survival, fetal therapy came into existence, which aims to preserve the function after birth to a higher degree and improve the quality of life.ObjectiveTo conduct a comprehensive bibliometric analysis of studies on fetal therapy in the past decade and explore the research trends and hotspots in this field.MethodsWe conducted a systematic search on the Web of Science Core Collection to retrieve studies related to fetal therapy published from 2012 to 2022. VOSviewer and CiteSpace were used to analyze the key features of studies, including annual output, countries/regions, institutions, authors, references, research hotspots, and frontiers.ResultsA total of 9,715 articles were included after eliminating duplicates. The annual distribution of the number of articles showed that the number of articles published in fetal therapy had increased in the past decade. Countries and institutions showed that fetal therapy is more mature in the United States. Author analysis showed the core investigators in the field. Keyword analysis showed the clustering and emergence frequency, which helped summarize the research results and frontier hotspots in this field. The cocited references were sorted out to determine the literature with a high ranking of fetal therapy in recent years, and the research trend in recent years was analyzed.ConclusionsThis study reveals that countries, institutions, and researchers should promote wider cooperation and establish multicenter research cooperation in fetal therapy research. Moreover, fetal therapy has been gradually explored from traditional surgical treatment to gene therapy and stem cell therapy. In recent years, fetoscopic laser surgery, guideline, and magnetic resonance imaging have become the research hotspots in the field.

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Section: Discussionmentioning

confidence: 99%

Trends in research related to fetal therapy from 2012 to 2022: a bibliometric analysis

Jia,

Liang,

Liu

et al. 2024

Front. Pediatr.

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“…Fetal surgery did not result in a vertical mother to child viral transmission or in a change of the maternal infectious status. Both cases were recently published in detail as “firsts” [13, 14]. Clearly, hepatitis and HIV call for a preoperative preventative masterplan to optimize handling instead of declining fetal surgery.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Spina Bifida Repair: Defendable Trespassing of MOMS Criteria Results in Commendable Personalized Medicine

Moehrlen,

Ochsenbein-Kölble,

Stricker

et al. 2023

Fetal Diagn Ther

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Introduction We hypothesize that after publication of the quintessence of the MOMS-Trial, eligibility criteria for prenatal spina bifida repair may be modified if a tenable argumentation underlies this decision. Methods Our first 154 fetal surgery patients were analyzed with particular focus on how many, which, and why the original eligibility criteria, set forth by the MOMS Trial Protocol, were disobeyed, and what the eventually detectable, negative and positive, impact of these deviations on outcomes was. Results A total of 152 patients (2 missing consent) were included (100%). In 69 patients (45.4%), a total of 89 eligibility criteria were disobeyed. In 54 (35.6%) cases, maternal criteria were concerned: Gestational age at operation of >25+6 weeks in 17 (11.2%), uterine pathologies in 13 (8.6%) women, preoperative BMI≥35 kg/m2 in 12 (7.9%), previous hysterotomy in 7 (4.6,%), previous prematurity in 3 (2%), HIV/hepatitis B in 2 (1.3%), psychosocial issues in 2 (1.3%), and placenta praevia in 1 (0.7%). In 32 (21.1%) cases, fetal criteria were disobeyed: Fetal anomaly unrelated to spina bifida in 19 (12.5%), no/minimal evidence of hindbrain herniation in 13 (8.6%), and severe kyphosis in 2 (1.3%). We could not identify cases where non-observation of criteria led to clear-cut maternal and/or fetal disadvantages. Conclusion This study shows that MOMS-Trial eligibility criteria for prenatal spina bifida repair should be modified or even abandoned with adequate medical and ethical argumentation, and with written parental informed consent after non-directive, full disclosure counseling. This clear cut change of paradigm is a necessity as it leads towards personalized medicine allowing more fetuses to benefit from fetal surgery than would have benefitted with the former published MOMS criteria in place.

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Fetal-Maternal Surgery for Spina Bifida in a HIV-Infected Mother

Cited by 2 publications

References 14 publications

Trends in research related to fetal therapy from 2012 to 2022: a bibliometric analysis

Trends in research related to fetal therapy from 2012 to 2022: a bibliometric analysis

Prenatal Spina Bifida Repair: Defendable Trespassing of MOMS Criteria Results in Commendable Personalized Medicine

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