Fully Percutaneous Fetoscopic Repair of Myelomeningocele: 30-Month Follow-up Data

Abstract

lead to fetal injury and long-term neurodevelopmental complications. We do not have the evidence or answers we need to pinpoint the timing of delivery with great accuracy, but such a study points us toward next steps. What is sorely needed is another study such as DIGITAT that is adequately powered for the long-term outcomes of interest. In addition, we need better tools for screening, diagnosis, and follow-up of FGR. As such incremental studies are conducted and provide more insight; as clinicians, we need to incorporate the data into our day-to-day management of these patients.-ABC)

Complex gastroschisis: a new indication for fetal surgery?

“…Moreover, it is unique in resolving the Achilles' heel of fetal surgery, which is preterm delivery 95 . Laparotomy-assisted fetoscopy rarely causes PPROM at < 30 weeks and has a low prematurity rate and a mean gestational age at birth of 37.6 weeks as compared to 33.0 weeks for percutaneous fetoscopy 90,96,97 and 34.0 weeks for open repair 86 . This technique also allows term and planned vaginal delivery in 71% and 47% of cases, respectively 83 .…”

Intrauterine surgery: how far we have come in 30 years

“…The future will show whether less invasive fetoscopic approaches provide the same or even better long‐term results regarding motor function and quality of life than those of the MOMS follow‐up cohort, in which 29% of the prenatal‐surgery group were able to walk independently, without orthotics or assistive devices, and only 7% were unable to walk at school age, as compared to 11% and 20%, respectively, in the postnatal‐surgery group 16 . The 30‐month follow‐up data from a single‐center, non‐randomized study population having undergone percutaneous fetoscopic repair, with a follow‐up rate of 72%, give further grounds for cautious optimism: 46% of children were able to walk independently while 16% were unable to walk 17 . The mean gestational age at delivery, however, was 33 weeks.…”

UOG now and beyond!

“…This issue also includes high‐impact research papers which highlight the breadth of topics the Journal now covers and in which ultrasound plays an instrumental or supporting role. These include perinatal genetics 2 , fetal surgery 3–5 and artificial intelligence 6 , the latter being a new area that shows the potential to transform ultrasound imaging 7–9 . Some of the contributors to the research papers in this issue also published in the first issue of the Journal in 1991 10 : Tom Bourne 11 , current President of ISUOG, and Davor Jurkovic 12 , and their research groups have contributed significantly to the gynecological content of UOG over the past 30 years 13–16 .…”