Reproductive outcomes in subsequent pregnancies after a pregnancy complicated by open maternal-fetal surgery (1996-2007).
OBJECTIVE
The reproductive and gynecologic outcomes for women after the pregnancy complicated by open maternal-fetal surgery (OMFS) were evaluated.


METHODS
The retrospective review identified 93 women with OMFS from a single institution (1996-2007). Consent and questionnaires were sent to women. Institutional review board approval was obtained from the Committee for Protection of Human Subjects.


RESULTS
The total return rate was 57.3%. Total pregnancies reported were 47, with 36 delivering after 20 weeks' gestation. The uterine dehiscence and rupture rates were 14% and 14%, respectively. Fetal anomalies occurred in 4 subsequent pregnancies. Normal conception occurred in 98% of subsequent pregnancies. Gynecologic issues were reported by 8 women, with infertility, abdominal pain, and ovarian and uterine factors.


CONCLUSIONS
The reproductive outcomes of uterine dehiscence (14%) and rupture (14%) in a subsequent pregnancy continue to be a major counseling issue for OMFS. Fertility and gynecologic factors do not appear to be increased for women undergoing OMFS.
Wilson
R Douglas
RD
Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Lemerand
Kerrie
K
Johnson
Mark P
MP
Flake
Alan W
AW
Bebbington
Michael
M
Hedrick
Holly L
HL
Adzick
N Scott
NS
D015746:Abdominal Pain / Q000453:epidemiology; D000022:Abortion, Spontaneous / Q000453:epidemiology; D000013:Congenital Abnormalities; D005260:Female; D005315:Fetal Diseases / Q000601:surgery; D005333:Fetus / Q000601:surgery*; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology; D008599:Menstruation Disturbances / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000453:epidemiology; D011795:Surveys and Questionnaires; D000267:Tissue Adhesions / Q000453:epidemiology; D014597:Uterine Rupture / Q000453:epidemiology