Maternal-fetal surgery for myelomeningocele: neurodevelopmental outcomes at 2 years of age.
OBJECTIVE
This study was undertaken to examine short-term neurodevelopmental outcomes in children with myelomeningocele (MMC) who underwent in utero neurosurgical closure.


METHODS
Between 1998 and 2002, 51 fetuses underwent in utero MMC closure at our Center. Thirty (63%) of these children have returned for neurodevelopmental testing at 2 years of age using the Bayley Scales of Infant Development and Preschool Language Scales.


RESULTS
Overall shunt rate was 43% in this group. Neurodevelopmental testing found 67% with cognitive language and personal-social skills in the normal range, 20% with mild delays, and 13% with significant delays. Children with shunted hydrocephalus scored lower than those with unshunted ventriculomegaly.


CONCLUSIONS
Children who have undergone fetal MMC closure have characteristic neurodevelopmental deficits that do not appear worsened by fetal surgery, and developmental outcomes may be improved by decreasing the need for ventriculoperitoneal shunting.
Johnson
Mark Paul
MP
The Center for Fetal Diagnosis and Treatment, Philadelphia, PA 19104, USA. johnsonma@email.chop.edu
Gerdes
Marsha
M
Rintoul
Natalie
N
Pasquariello
Patrick
P
Melchionni
Jeanne
J
Sutton
Leslie N
LN
Adzick
N Scott
NS
D002657:Child Development; D002675:Child, Preschool; D005260:Female; D005315:Fetal Diseases / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008591:Meningomyelocele / Q000601:surgery*; D009048:Motor Skills; D011247:Pregnancy; D016896:Treatment Outcome