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Article

Outcomes after In Utero Myelomeningocele Repair Based on Delivery Location

1
Departments Obstetrics, Gynecology & Reproductive Sciences and Pediatric Surgery, Division of Maternal-Fetal Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston and Children’s Memorial Hermann Hospital, Houston, TX 77030, USA
2
Departments of Pediatric Surgery and Obstetrics, Gynecology & Reproductive Sciences, McGovern Medical School at the University of Texas Health Science Center at Houston and Children’s Memorial Hermann Hospital, Houston, TX 77030, USA
3
Division of Pediatric Neurosurgery, Department of Pediatrics, and Department of Pediatric Surgery, UTHealth the University of Texas McGovern Medical School, Houston, TX 77030, USA
4
Department of Pediatrics, McGovern Medical School—UTHealth, Houston, TX 77030, USA
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Department of Women’s Health, The University of Texas at Austin, Dell Medical Shool, Austin, TX 77030, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(11), 3443; https://doi.org/10.3390/jcm9113443
Received: 6 October 2020 / Revised: 22 October 2020 / Accepted: 23 October 2020 / Published: 27 October 2020
(This article belongs to the Special Issue New Prospects for Prenatal Diagnosis and Fetal Therapy)
Maternal and pediatric delivery outcomes may vary in patients who underwent open fetal myelomeningocele repair and elected to deliver at the fetal center where their fetal intervention was performed versus at the referring physician’s hospital. A prospective cohort study of 88 patients were evaluated following in utero open fetal myelomeningocele repair at a single fetal center between the years 2011–2019. Exclusion criteria included patients that delivered within two weeks of the procedure (n = 6), or if a patient was lost to follow-up (n = 1). Of 82 patients meeting inclusion criteria, 36 (44%) patients were delivered at the fetal center that performed fetal intervention, and 46 (56%) were delivered locally. Comparative statistics found that with the exception of parity, baseline characteristics and pre-operative variables did not differ between the groups. No differences in oligohydramnios incidence, preterm rupture of membranes, gestational age at delivery or delivery indications were found. Patients who delivered with a referring physician were more likely to be multiparous (p = 0.015). With the exception of a longer neonatal intensive care unit (NICU) stay in the fetal center group (median 30.0 vs. 11.0 days, p = 0.004), there were no differences in neonatal outcomes, including wound dehiscence, cerebrospinal fluid leakage, patch management, ventricular diversion, or prematurity complications. Therefore, we conclude that it is safe to allow patients to travel home for obstetric and neonatal management after open fetal myelomeningocele repair. View Full-Text
Keywords: in utero open fetal myelomeningocele repair; obstetric and neonatal management; delivery location; neonatal outcomes; maternal outcomes; referring physician; spina bifida in utero open fetal myelomeningocele repair; obstetric and neonatal management; delivery location; neonatal outcomes; maternal outcomes; referring physician; spina bifida
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MDPI and ACS Style

Bergh, E.P.; Tsao, K.; Austin, M.T.; Fletcher, S.A.; Lopez, S.M.; Moise, K.J., Jr.; Johnson, A.; Papanna, R. Outcomes after In Utero Myelomeningocele Repair Based on Delivery Location. J. Clin. Med. 2020, 9, 3443. https://doi.org/10.3390/jcm9113443

AMA Style

Bergh EP, Tsao K, Austin MT, Fletcher SA, Lopez SM, Moise KJ Jr., Johnson A, Papanna R. Outcomes after In Utero Myelomeningocele Repair Based on Delivery Location. Journal of Clinical Medicine. 2020; 9(11):3443. https://doi.org/10.3390/jcm9113443

Chicago/Turabian Style

Bergh, Eric P., Kuojen Tsao, Mary T. Austin, Stephen A. Fletcher, Suzanne M. Lopez, Kenneth J. Moise Jr., Anthony Johnson, and Ramesha Papanna. 2020. "Outcomes after In Utero Myelomeningocele Repair Based on Delivery Location" Journal of Clinical Medicine 9, no. 11: 3443. https://doi.org/10.3390/jcm9113443

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