(Am J Obstet Gynecol. 2019;220:494.e1–494.e7) Open maternal-fetal surgery (OMFS) for fetal myelomeningocele (fMMC) is associated with a significant reduction in morbidity related to spina bifida. OMFS for fMMC may be associated with adverse outcomes in subsequent pregnancies, but there are limited data available. There is a uterine rupture risk of 4% to 9% associated with a classical hysterotomy, but its unclear whether this risk is similar in hysterotomy for OMFS for fMMC. In 2012, the Fetal Myelomeningocele Consortium, now consisting of 25 institutions, was created to establish a registry of patients undergoing fMMC closure. This study aimed to investigate the maternal and neonatal outcomes in subsequent pregnancies following OMFS for fMMC closure.

There are high rates of fetal growth restriction, delivery for non-reassuring fetal status, and evidence of placental insufficiency among affected pregnancies, suggesting a role for antepartum surveillance. © 2017 John Wiley & Sons, Ltd.

(Am J Obstet Gynecol. 2020;222:179.e1–179.e9) Placenta accreta spectrum (PAS) is a major risk factor for maternal injury and death, with an estimated morbidity rate of 24% to 67% and an estimated mortality rate of up to 7%. The current recommendations for treatment of PAS focus on immediate cesarean hysterectomy, but given the significant morbidity of PAS, new treatment strategies are needed. This study assessed the outcomes of patients with an antenatal diagnosis of placenta percreta that was managed with delayed hysterectomy versus patients who had an immediate cesarean hysterectomy.