title: Pregnancy and delivery after myelomeningocele repair, ventriculoperitoneal shunt implantation, and augmentation cystoplasty.
abstract: BACKGROUND
  Management of pregnancy and delivery of a patient with a history of myelomeningocele requires a multidisciplinary team approach.
  
  
  METHODS
  We report a case of pregnancy and delivery by a patient who had a history of myelomeningocele surgical repair, ventriculoperitoneal (VP) shunt, and bladder augmentation enterocystoplasty. Regarding types of delivery style, anesthesiologists recommended a Cesarean section under general anesthesia. However, urologists recommended a vaginal delivery because they were concerned that she would require a nephrostomy because of severe adhesion between her uterus and the neobladder if she had a Cesarean section.
  
  
  CONCLUSIONS
  In a pregnant myelomeningocele patient with a VP shunt, neurosurgeons are expected to manage the VP shunt during pregnancy and delivery. The possible types of delivery style and the best options based on the neurological deficit should be discussed together with a medical team.
authors.affiliation: Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama-Shi, Okayama, 700-8558, Japan. mrkameda@gmail.com.
authors.forename: Masahiro
authors.identifier: http://orcid.org/0000-0003-3665-0892
authors.initials: M
authors.lastname: Kameda
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama-Shi, Okayama, 700-8558, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Takahara
authors.affiliation: Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama-Shi, Okayama, 700-8558, Japan.
authors.forename: Motomu
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama-Shi, Okayama, 700-8558, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama-Shi, Okayama, 700-8558, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Morihara
authors.affiliation: Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama-Shi, Okayama, 700-8558, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Date
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D008591:Meningomyelocele / Q000000981:diagnostic imaging* / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000601:surgery; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects / Q000639:trends*
keywords: Augmentation cystoplasty; Spina bifida; Vaginal delivery