Fetoscopic Repair of Meningomyelocele.
BACKGROUND
Currently, maternal-fetal surgery for repair of myelomeningocele requires an upper-segment hysterotomy, which likely increases maternal postsurgical risks. If fetoscopic repair of myelomeningocele achieves similar or better fetal outcomes while decreasing maternal risks, it would be a better option.


METHODS
A patient with a fetus with a L3-S1 meningomyelocele underwent a laparotomy and fetoscopic repair using a two-port, in-CO2 approach at 23 2/7 weeks of gestation. The neonate was delivered at 30 6/7 weeks of gestation by lower segment cesarean delivery and required no further surgery, has not needed a shunt (5 months), and has normal, age-appropriate neurologic function.


CONCLUSIONS
This innovative fetoscopic approach may offer an alternative to open fetal surgery and may prevent the need for hysterotomy and cesarean delivery in index and subsequent pregnancies.
Baylor College of Medicine, Departments of Obstetrics and Gynecology, Neurosurgery, and Surgery, Texas Children's Fetal Center, Texas Children's Hospital, Houston, Texas.
Michael A
MA
Belfort
William E
WE
Whitehead
Alireza A
AA
Shamshirsaz
Rodrigo
R
Ruano
Darrell L
DL
Cass
Oluyinka O
OO
Olutoye
D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000601:surgery*; D005332:Fetoscopy / Q000379:methods*; D006801:Humans; D008591:Meningomyelocele / Q000601:surgery*; D011247:Pregnancy