title: Use of bipedicular advancement flaps for intrauterine closure of myeloschisis.
abstract: Several groups have begun to explore the feasibility and utility of intrauterine closure of myelomeningocele. A subset of these fetuses have defects which fall into the category of myeloschisis, and therefore have inadequate skin to enable primary closure. After considerable discussion, it was decided to utilize bipedicular flaps to close these lesions. The procedure is described, and representative examples are shown. To date, 13 of 56 fetuses have required this approach for closure in utero. While this technique generally provides adequate coverage of the dural sac, the cosmetic results have been less than optimal.
authors.affiliation: Department of Neurosurgery and Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN 37232, USA. kyle.mangels@mcmail.vanderbilt.edu
authors.forename: K J
authors.initials: KJ
authors.lastname: Mangels
authors.forename: N
authors.initials: N
authors.lastname: Tulipan
authors.forename: J P
authors.initials: JP
authors.lastname: Bruner
authors.forename: D
authors.initials: D
authors.lastname: Nickolaus
mesh_terms: D036861:Delivery, Obstetric; D005240:Feasibility Studies; D005333:Fetus / Q000601:surgery*; D006801:Humans; D020883:Hysterotomy; D007231:Infant, Newborn; D008591:Meningomyelocele / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000009:adverse effects; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D014945:Wound Healing