Journal
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 194, Issue 4, Pages 1145-1150Publisher
MOSBY, INC
DOI: 10.1016/j.ajog.2006.01.072
Keywords
myelomeningocele; spina bifida; fetal surgery; neurodevelopment; ventriculomegaly
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Objective: This study Was undertaken to examine short-term neurodevelopmental outcomes in children with myelomeningocele (MMC) who underwent in Utero neurosurgical closure. Study design: Between 1998 and 2002, 51 fetuses underwent in utero MMC closure at our Center. Thirty (63%) of these children have returned for neurodevelopmental testing at 2 years of age using the Bayley Scales of Infant Development and Preschool Language Scales. Results: Overall shunt rate was 43% in this group. Neurodevelopmental testing found 67% with cognitive language and personal-social skills in the normal range, 20% with mild delays, and 13% with significant delays. Children with Shunted hydrocephalus scored lower than those with unshunted ventriculomegaly. Conclusion: Children who have undergone fetal MMC Closure have characteristic neurodevelopmental deficits that do not appear worsened by fetal Surgery, and developmental outcomes may be improved by decreasing the need for ventriculoperitoneal shunting. (C) 2006 Mosby, Inc. All rights reserved.
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