caa a22 4500 463180437 CHVBK 20180406164837.0 cr unu---uuuuu 170326e20070401xx s 000 0 eng 10.1007/s00381-006-0261-x doi (NATIONALLICENCE)springer-10.1007/s00381-006-0261-x Assessment of neurosurgical outcome in children prenatally diagnosed with myelomeningocele and development of a protocol for fetal surgery to prevent hydrocephalus [Elektronische Daten] [Helder Zambelli, Edmur Carelli, Donizeti Honorato, Sérgio Marba, Giselle Coelho, Aline Carnevalle, Alexandre Iscaife, Elton da Silva, Ricardo Barini, Lourenço Sbragia] Introduction: Prenatal diagnosis of myelomeningocele (MMC) has permitted a better planning for optimum management of the disease. More recently, it has allowed for a possible intrauterine repair of the spinal defect. Objective: To describe neurosurgical outcome in children with myelomeningocele and follow-up at a referral center in Fetal Medicine. Patients were characterized for the development of a protocol suitable for fetal surgery, and fetuses who were possible candidates for intrauterine surgery were identified. Materials and methods: A retrospective descriptive analysis was performed of 98 cases of fetal myelomeningocele, seen at CAISM-UNICAMP, from January 1994 to December 2002, identifying cases with a possible indication for fetal surgery. Results: Mean gestational age at diagnosis was 29weeks (17-39); level of lesion was above the sacral region in 92.84%; association with hydrocephalus occurred in 78.57%. During clinical course, 82.5% of patients had neurogenic bladder and 60% had neural and mental deficits. Potential intrauterine repair rate was 11.57%, using criteria from the protocol developed in our service. Conclusion: Myelomeningocele is associated with severe and frequent sequelae. In virtually 12% of our cases, fetal surgery could have been offered as a therapeutic option. Springer-Verlag, 2007 Prenatal diagnosis nationallicence Myelomeningocele nationallicence Hydrocephalus nationallicence Fetal surgery nationallicence Zambelli Helder Discipline of Neurosurgery—Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut Carelli Edmur Discipline of Neurosurgery—Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut Honorato Donizeti Discipline of Neurosurgery—Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut Marba Sérgio Division of Neonatology—Department of Pediatrics, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut Coelho Giselle Discipline of Neurosurgery—Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut Carnevalle Aline Discipline of Neurosurgery—Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut Iscaife Alexandre Division of Pediatric Surgery—Department of Surgery, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut da Silva Elton Discipline of Neurosurgery—Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut Barini Ricardo Department of Obstetrics and Gynecology, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut Sbragia Lourenço Division of Pediatric Surgery—Department of Surgery, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut Child's Nervous System Springer-Verlag 23/4(2007-04-01), 421-425 0256-7040 23:4<421 2007 23 381 https://doi.org/10.1007/s00381-006-0261-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-006-0261-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Zambelli Helder Discipline of Neurosurgery—Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut NATIONALLICENCE 700 1- Carelli Edmur Discipline of Neurosurgery—Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut NATIONALLICENCE 700 1- Honorato Donizeti Discipline of Neurosurgery—Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut NATIONALLICENCE 700 1- Marba Sérgio Division of Neonatology—Department of Pediatrics, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut NATIONALLICENCE 700 1- Coelho Giselle Discipline of Neurosurgery—Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut NATIONALLICENCE 700 1- Carnevalle Aline Discipline of Neurosurgery—Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut NATIONALLICENCE 700 1- Iscaife Alexandre Division of Pediatric Surgery—Department of Surgery, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut NATIONALLICENCE 700 1- da Silva Elton Discipline of Neurosurgery—Fetal Medicine Group, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut NATIONALLICENCE 700 1- Barini Ricardo Department of Obstetrics and Gynecology, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut NATIONALLICENCE 700 1- Sbragia Lourenço Division of Pediatric Surgery—Department of Surgery, Universidade Estadual de Campinas-UNICAMP, Rua Alexander Fleming, 181, Barão Geraldo, 13084-970, Campinas-SP, Brazil aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/4(2007-04-01), 421-425 0256-7040 23:4<421 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer