Selection for Early Treatment of Myelomeningocele: a Retrospective Analysis of Selection Procedures

Stein, Sherman C.; Schut, Luis; Ames, Mary D.

doi:10.1111/j.1469-8749.1975.tb04668.x

Cited by 9 publications

(2 citation statements)

References 18 publications

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“…There are reports that early and aggressive surgery reduces complications and prevalence of death in the short term and that it also reduces the chances of urinary incontinence and duration of stay in long term follow-up. 11 In present study, there was no mortality in the neonatal period. Operating within first 3 days of life is the key to avoiding problems in early neonatal period.…”

Section: Discussionsupporting

confidence: 44%

Clinical Evaluation and Management of Children with Meningomyelocoele

Shukla¹,

Chaube²

2020

jebmh

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BACKGROUND Neural tube defects (NTDs) are one of the most common birth defects affecting the Central Nervous System (CNS) and is often associated with complex birth defects compatible with survival. 1 NTD is a general term for a congenital malformation of the central nervous system (CNS) occurring secondary to lack of closure of the neural tube and has a worldwide incidence of 1.0 to 10.0 per 1,000 births. Congenital malformations of spine and spinal cord are collectively termed as spinal dysraphism. It includes a heterogenous group of anomalies resulting from incomplete midline closure of osseous, mesenchymal and nervous tissue. 2 Most of these conditions are diagnosed at or soon after birth, but some are diagnosed late in childhood or in adulthood because of absence of clinical manifestations. We wanted to evaluate the causative factors, clinical features, management and postoperative complications of children with meningomyelocoele. METHODS This is a retrospective study and all children having meningomyelocoele born between April 2014 to May 2016 were included in the study. Clinical features, maternal educational status, size and location of the defect, operative details such as time to surgery and its relation to postoperative morbidity and mortality were recorded. RESULTS A total of 36 patients were evaluated in the study period. There were 20 (55.6%) males and 16 (44.4%) females. Most common location of MMC was in lumbar (83.3%) and followed by thoracolumbar (16.7%) regions. None of the mothers received folate supplementation. Hydrocephalus (n = 18), pelvicalyceal ectasia (n = 3), pes equinovarus (n = 7), Chiari II malformation (n = 4)), pelvicalyceal ectasia (n = 3), hip dysplasias (n = 2), accounted for additional anomalies. Short term complications following surgery were bladder dysfunction in 8 patients (22.2%), 7 patients (19.4%) had seizures, 6 patients (16.7%) had bacterial meningitis and 3 patients (8.3%) had severe hydrocephalus and 4 patients (11.1%) had ventriculitis. CONCLUSIONS Operating on patients with meningomyelocoele with in 72 hrs. of birth reduces complications, hospital stay and antibiotic usage.

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Section: Discussionsupporting

confidence: 44%

Clinical Evaluation and Management of Children with Meningomyelocoele

Shukla¹,

Chaube²

2020

jebmh

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“…However, in our study we determined a shunt infection in only 1 patient, and we suggest that shunt insertion at the same time as the correction operation may be appropriate. There are a few studies reporting that early and aggressive surgery reduces complications and death prevalence in the short-term, and that it reduces urinary incontinence as well as duration of stay in the nursery in long-term follow-up [19,20,21,22,23]. In our study, no neonates died during the neonatal period.…”

Section: Discussionmentioning

confidence: 56%

Clinical Characteristics of Neonatal Meningomyelocele Cases and Effect of Operation Time on Mortality and Morbidity

Bülbül

Can²,

Bülbül³

et al. 2010

Pediatr Neurosurg

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Objective: We aimed to evaluate the clinical features, short-term prognosis, and effect of operation time on mortality and morbidity in neonates with meningomyelocele. Methods: This prospective study was conducted between January 2006 and December 2008. Clinical features, defective area, existence of additional anomalies, operation time, and morbidity and mortality data were recorded. The effectof operation time on mortality and morbidity was evaluated. Results: Patients (n = 28) were assessed during the study period. Mean birth weight, height, and head circumference were found to be 3,160 ± 582 g, 46.2 ± 3.3 cm, and 36.7 ± 4.1 cm, respectively. None of the mothers received folate supplementation. Hydrocephaly (n = 13), pes equinovarus (n = 4), pelvicalyceal ectasia (n = 4), acetabular dysplasia (n = 2), Chiari II malformation (n = 2), and hydronephrosis (n = 2) accounted for additional anomalies. The mean postnatal age for surgical operation was 3.2 ± 2.8 days; mean length of hospital stay was 10.2 ± 9.7 days. The cases operated after 72 h were hospitalized longer, received antibiotherapies for a longer duration and had higher total complication rates (p = 0.04, 0.02, and 0.01, respectively). Conclusion: Surgical operation of patients with meningomyelocele within 72 h after delivery significantly reduces not only the duration of hospitalization and antibiotic usage, but also complication rates.

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Congenital Malformations of the Central Nervous System

Huang¹,

Doherty²

2018

Avery's Diseases of the Newborn

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Selection for Early Treatment of Myelomeningocele: a Retrospective Analysis of Selection Procedures

Cited by 9 publications

References 18 publications

Clinical Evaluation and Management of Children with Meningomyelocoele

Clinical Evaluation and Management of Children with Meningomyelocoele

Clinical Characteristics of Neonatal Meningomyelocele Cases and Effect of Operation Time on Mortality and Morbidity

Congenital Malformations of the Central Nervous System

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