Impact of maternal-fetal surgery for myelomeningocele on the progression of ventriculomegaly in utero.
OBJECTIVE
Intrauterine myelomeningocele (MMC) repair decreases hindbrain herniation and the need for postnatal ventriculoperitoneal shunting. We examined the impact of intrauterine repair on the progression of ventriculomegaly in utero.


METHODS
Fetuses with MMC were identified through computerized databases from June 1988 to April 2003. A retrospective cohort design was used to evaluate the impact of intrauterine repair on ventricular progression with a multivariate linear regression model that included baseline ventricle measurement, gestational age, level of lesion, and gender.


RESULTS
Fourteen fetuses with intrauterine repair and 39 fetuses with postnatal repair were identified. The natural history of progression of ventricular diameter increased in a linear fashion throughout gestation (0.57 mm/week). After adjusting for confounding variables, no transient or sustained difference was observed in the rate progression of ventriculomegaly between intrauterine and postnatal repair (0.27 +/- 0.35 mm/week; P=.45).


CONCLUSIONS
Intrauterine MMC repair does not impact the progression of ventriculomegaly.
Adelberg
Amy
A
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, USA. adelberg@med.unc.edu
Blotzer
Angela
A
Koch
Gary
G
Moise
Rachael
R
Chescheir
Nancy
N
Moise
Kenneth J
KJ
Wolfe
Honor
H
D002552:Cerebral Ventricles / Q000473:pathology*; D018450:Disease Progression; D005315:Fetal Diseases / Q000453:epidemiology*; D046128:Fetal Therapies; D006801:Humans; D016014:Linear Models; D008591:Meningomyelocele / Q000601:surgery*