OC16.02: Percutaneous fetoscopic 3‐layer closure of large open spina bifida defects using a bilaminar skin substitute

Abstract

Oral communication abstracts83 to 450 minutes. A total of 42 cases already delivered (4 uneventful vaginal), no uterine dehiscence observed. PPROM occurred in 34/42 (81%) cases. Fetuses remained in utero on average for 6,1w (5d to 13w). Mean GA at delivery was 32,6w, only 16,7% below 30w, mean birthweight was 1906g (890 to 2960g). No intrauterine demise occurred. Two neonatal deaths due to sepsis occurred. VP shunt was placed in 42% cases and two infants died due to shunt related infection. Long-term follow up was obtained in 38 cases, mean 8,9 months. The functional level of the lesion was assessed in total 23 cases and was found to be one or more levels better than the anatomical level in 70%. Conclusions: Entirely percutaneous fetoscopic correction is feasible and safer than open fetal approach; however, it is associated with an increased risk of PPROM. Fetoscopic correction can be used in cases were open surgery cannot. The CECAM technique statistically significantly improves motor outcome, when compared to MOMS trial results, so it is not only safer for mothers but also better for babies.