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.
Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
R Douglas
RD
Wilson
Kerrie
K
Lemerand
Mark P
MP
Johnson
Alan W
AW
Flake
Michael
M
Bebbington
Holly L
HL
Hedrick
N Scott
NS
Adzick
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