OC14.04: Brain abnormalities in fetuses and infants that underwent a prenatal neural tube defect (NTD) repair using a fetoscopic and open approach

Prevalence of supratentorial anomalies assessed by magnetic resonance imaging in fetuses with open spina bifida

“…Our results are in line with those of that study, showing that the posterior part of the CC is affected most when partial CC anomalies are detected. The prevalence of heterotopia in this study was 4.3%, which is comparable to the rate of 3% reported previously by Sanz Cortes et al 19 . in fetuses with OSB before surgery.…”

“…The prevalence of heterotopia in this study was 4.3%, which is comparable to the rate of 3% reported previously by Sanz Cortes et al 19 in fetuses with OSB before surgery. It should be stressed that, if we also take into account other ventricular wall anomalies, this number rises to 19.1%, which is close to the 12% incidence of heterotopias observed at the 6-week postsurgery follow-up in the cohort of Sanz Cortes et al 19 , and the rate of 11.6% in a study by Nagaraj et al 37 based on postnatal MRI. Ventricular wall anomaly may be interpreted as a CNS anomaly that may lead to heterotopia or even an underdiagnosed heterotopia, due to lower imaging quality owing to the early GA at evaluation, smaller size of the structures, lower imaging resolution and increased fetal movements.…”

“…in fetuses with OSB before surgery. It should be stressed that, if we also take into account other ventricular wall anomalies, this number rises to 19.1%, which is close to the 12% incidence of heterotopias observed at the 6‐week postsurgery follow‐up in the cohort of Sanz Cortes et al 19 ,. and the rate of 11.6% in a study by Nagaraj et al 37 .…”

“…However, it remains unclear whether these anomalies are a consequence of OSB, rather than a primary condition, and when exactly they develop during prenatal life 2 . A recent study demonstrated that detailed brain magnetic resonance imaging (MRI) can reveal subtle anomalies with potential clinical significance in a high proportion of fetuses eligible for spina bifida repair 19 . The precise relationship between these anomalies and the clinical spectrum of OSB should be established better to clarify whether they have prognostic significance 15,17 .…”

Heated humidified carbon dioxide for partial uterine insufflation in fetoscopic myelomeningocele repair: insights from animal model

“…From a pragmatic standpoint, evidence from more than 150 humans who had undergone fetoscopic MMC repair did not show any significant detrimental effects, even after prolonged exposure to CO 2 . However, targeted studies on long‐term developmental outcome are lacking and there are limited data on neurodevelopmental outcome after fetoscopic MMC repair. Examination of the placenta and membranes of humans exposed to intrauterine CO 2 has shown no evidence of increased apoptosis or placental underperfusion.…”